Background
New federal rules finalized in 2024 will promote transparency and accessibility of health information and support consumers in health care decision-making. A key component of these new rules addresses information and processes related to prior authorization for items and services, including:
- Electronic access to information for patients on prior authorization requests and decisions;
- Electronic access to information for providers on when prior authorization is required and what information is required to accompany a prior authorization request;
- Electronic exchange of prior authorization requests and decisions between providers and payers; and
- Electronic exchange of prior authorization information across payers.