IPSIS Voices Support for Proposed Prior Authorization Reforms

IPSIS joined 118 other medical societies in submitting a letter voicing support for meaningful prior authorization reforms in response to the Centers for Medicare and Medicaid’s proposed rule for Medicare Advantage and the Medicare prescription drug benefit programs. The proposed prior authorization reforms reflect many of the policies for which our organizations have been advocating for many years including:

• increased clinical validity of coverage criteria;
  
• restrictions on retroactive denials after prior authorization approvals;
  
• a grace period for patients switching plans to promote continuity of care;
  
• greater physician-patient autonomy in determining where care can be provided and by whom;
  
• volume reduction by encouraging gold carding programs; and
• prior authorization information at the point-of-care.
  

If finalized, the proposed rule will target the inappropriate use of authorization requirements by Medicare Advantage plans to delay, deny, and disrupt the provision of medically necessary care to patients.