Blog Logo
Blog Logo

Michael A. Cassidy

Shareholder

Chair, Business & Finance Department

Contact information

BOOKMARK SHARE
View All News & Insights
BACK TO Michael A.’S PROFILE

Reforming Prior Authorization Process: Federal and Pennsylvania

Michael A. Cassidy, mcassidy@tuckerlaw.com, (412) 594-5515

Both the federal government and the Pennsylvania state government are taking steps to reform the prior authorization process. Take a look at the Pennsylvania Insurance Department press release that was issued November 3, 2022, touting the passage and signing of Pennsylvania Act 146, which is described as creating a new and more effective process for prior authorization review.

Pennsylvania Act 146 is not intended to take effect until January 1, 2024, so there should be adequate time to review and implement the 50 page statute.

Along a similar vein, CMS (Centers for Medicare and Medicaid Services) has proposed to expand access to health information and improve the prior authorization process.

Here is the CMS press release announcing that effort along with the CMS Fact Sheet describing the process.

Note that the process is a continuation of a rule that was first introduced in December of 2020. A revised proposed rule has been issued. Comments are due by March 13, 2023. Additional information is available on the CMS website.

For more information, contact Mike Cassidy at mcassidy@tuckerlaw.com, or at (412) 594-5515. Visit our Med Law Blog here.

December 12, 2022

Serving our clients successfully since 1900

The same attributes that have anchored over a century of success are still our guiding principles today.

Stay up-to-date on the latest News & Insights by subscribing to our alerts

Enter your email address below and be notified when we post new information.