Stop “Black Box” Prior Authorization

IPSIS is concerned that recent prior authorization proposals from the Health Level Seven International (HL7) Da Vinci Project will be detrimental to realizing the unified, standards-based prior authorization system mandated by the Centers for Medicare and Medicaid Services (CMS).

In an October 13, 2025, letter, signed by IPSIS and more than 30 national physician organizations, we emphasized the importance of real-time adjudication of prior authorizations to improve patient outcomes and reduce administrative burdens. We also shared our specific concerns about the potential detrimental impacts of:

• shifting coverage information away from physicians to back offices, and
• creating opaque, payer-specific coverage companion guides.

This industry push-back seeks to undermine reforms critical to increasing transparency about the wide range of coverage variations between American health plans.

IPSIS advocates for evidence-based policies that expand access to safe, effective treatments for individuals suffering from debilitating pain. Help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.