AHA - American Hospital Association

04/15/2024 | News release | Distributed by Public on 04/15/2024 16:13

CMS administrator highlights response to Change Healthcare cyberattack, prior authorization improvements

The Change Healthcare cyberattack was a significant event that caught many off guard, said the Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure, reiterating the agency's commitment to supporting impacted hospitals. Brooks-LaSure stated the Administration is listening to stakeholders and when possible, facilitating solutions, noting the importance of meeting the needs of providers.

In addition, Brooks-LaSure celebrated important improvements CMS made to promote greater transparency for prior authorization criteria. CMS took steps earlier this year finalizing new regulations to streamline and reduce burden associated with the prior authorization process in Medicare Advantage and fee-for-service and managed care programs for Medicaid and the Children's Health Insurance Program.

CMS continues to hear from patients and providers over some commercial insurer prior authorization denials and delays, Brooks-LaSure said, noting that the volume of frustration has "just exploded." The private sector, she said, has an opportunity to step up with solutions of their own to address concerns.

"I've told the health plans this: it doesn't have to all be regulated [by the federal government], there may be things that they can do," Brooks-LaSure said.