The AAMC submitted comments Thursday (PDF) in response to the Centers for Medicare & Medicaid Services (CMS) proposed rule on prior authorization and interoperability for prescription drugs.
The AAMC supported the agency’s efforts to advance interoperability and standardize the prior authorization process to support access, improve patient care, and reduce administrative burden. However, the association requested that the CMS align timelines for prior authorization decisions across payers regulated by the agency. Specifically, the AAMC asked the CMS to adopt a timeliness requirement for prior authorization decisions within 24 hours of receipt of a request for urgent items or services and 48 hours for nonurgent care decisions for drug and nondrug items and services. Comments also asked the agency to restrict the use of prior authorization for substance use disorder treatment to ensure access to time-sensitive care and include oversight and transparency on the use of certain artificial intelligence technology in prior authorization, and responded to a request for information on plans’ use of step therapy.
Further, the AAMC responded to a request for information that the agency included on increasing health care resiliency and enhancing cybersecurity. The AAMC indicated its support for safeguards, but stressed that before proposing any requirements, the agency should engage in a consensus-driven approach to receive feedback from stakeholders and to appropriately understand the costs associated with implementing any new requirements. The association also called on the CMS to explore options for ensuring continuity of payments to providers affected by cyberattacks.