As state legislatures intensify efforts to reform prior authorization processes, these changes may reflect broader regulatory trends such as those outlined by CMS in rules like...
Kim Boyd
Recent Posts
From Federal to State: The Vital Importance of Vigilance in DEA Rule Changes and Policy Shifts for Telehealth Substance Use Disorder Treatment
The Controlled Substances Act (CSA) in the United States imposes stringent regulations governing the prescribing, dispensing, and usage of narcotic drugs, especially those...
CMS Rule Drives New Era of API-Enabled Data Sharing & Prior Authorization Reform
On January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) unveiled a long-awaited final rule aimed at advancing interoperability and enhancing prior authorization...
Washington State Takes a Leap to Require FHIR APIs and Reshape Prior Authorization
Washington State has taken a pioneering leap in reshaping the landscape of prior authorization, racing ahead of federal guidelines by mandating the use of FHIR (Fast Healthcare...
Decoding Medicare's Proposed Rule: Insights for Health IT Stakeholders
Yearly adjustments in healthcare policies are the norm, with some years marking more notable changes. Among these, the Centers for Medicare & Medicaid Services (CMS) consistently...
Could Gold-Carding be a Transformative Factor for Prior Authorization?
The concept of "Gold-carding” is an emerging policy trend that has the potential to significantly transform prior authorization (and claims) procedures. As an evolving concept, it...
While Electronic Prescribing is Mature, Policy Is Far from Static. What You Need to Know About the Ever-Evolving Patchwork of State ePrescribing and EPCS Policy
In recent years, electronic prescribing (ePrescribing) and electronic prescribing of controlled substances (EPCS) have become the norm in the healthcare industry. While the...
Pharmacy Interoperability: A Review of POCP's Response to ONC's Proposed Rule on Health Data, Tech, & Interoperability
Point-of-Care Partners (POCP) recently responded to the Office of the National Coordinator for Health Information Technology (ONC) proposed rule on "Health Data, Technology, and...
HHS Proposed Rule to Standardize Attachments: A Step Back from Automation
On December 21, 2022, the Department of Health and Human Services (HHS) issued a proposed rule that would regulate standards for health care attachment transactions. These include...
Recap of the Changes to Medicare Advantage and Medicare Prescription Drug Benefit Proposed Rule
Our December 20 blog shared highlights from the CMS proposed rule for Advancing Interoperability and Improving Prior Authorization Processes, intended to improve patient and...
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