The Impact of the New Prior Authorization Rule

Prior authorization means getting approval from your health plan before scheduling a medical service, but many clinicians and patients say prior authorization has become an administrative nightmare, delaying or even denying needed medical care. In mid-January, the Centers for Medicaid and Medicare Services (CMS) issued a final rule designed to address some of the widespread difficulties. In this conversation, Andrea Preisler, senior associate director of administrative simplification policy at the AHA, Jennifer Cameron, executive director of Patient Access at Children's National Health System and David Jacobson, M.D., division chief of blood and marrow transplantation at Children's National Hospital, discuss what the new prior authorization rule means for making sure clinicians can do what they do best: taking care of their patients.