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WEDI Comments: New Rules to Address Prior Authorization and Reduce Burden on Patients and Providers

December 15, 2020

WEDI a named advisor to the Secretary of the U.S. Department of Health and Human Services (HHS) in the Health Insurance Portability and Accountability Act of 1996 (HIPAA), is a frequent commenter on administrative simplification regulations. As a multi-stakeholder organization comprised of health plans, providers, vendors, standards development organizations, and government representatives, WEDI offers a wealth of experience in advising HHS and educating the industry on a wide range of health information technology (IT) regulatory requirements.

CMS has issued a Notice of Proposed Rulemaking entitled Medicaid Program; Patient Protection and Affordable Care Act; Reducing Provider and Patient Burden by Improving Prior Authorization Processes, and Promoting Patients’ Electronic Access to Health Information for Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-facilitated Exchanges; Health Information Technology Standards and Implementation Specifications. WEDI is very appreciative of the proposed solutions to address the burdens associated with prior authorization. Given the importance of this proposal and the impact to the industry, WEDI believes the time afforded to submit formal comments is insufficient and hereby request an extension of thirty days.

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