At first glance, the latest Centers for Medicare & Medicaid (CMS) Request for Information (RFI) is short, coming in at 3 pages. But don’t be fooled. It is asking some big,...
Observations from the Field: Understanding and Leveraging CMS-0057 for Strategic Advantage
In our role as health IT consultants, we consistently encounter a common issue when discussing the CMS Interoperability and Prior Authorization Final Rule (CMS-0057) with...
Beyond Compliance: Achieving Excellence in Execution – Mastering Iterative Improvements
The final blog in our series, focusing on Execution & Iteration, brings our compliance journey to its most dynamic phase. Read the first and second blogs in the series to catch up...
Beyond Compliance: Transforming Insights into Impact – The Journey from Analysis to Action
In the first blog of this series, we broached the complexities of the "Assess and Analyze" phase, emphasizing the importance of a thorough understanding of the regulatory...
Beyond Compliance: The Strategic Roadmap – Starting with Assessment and Analysis
The CMS rule on advancing interoperability and improving prior authorization (CMS-0057-F) sets a foundation for future policymaking. As payers embark on this compliance journey,...
Reflecting on HIMSS24: Insights and Innovations from the Front Lines
As spring blossoms each year, the healthcare IT community gears up for one of its most anticipated events: the Healthcare Information and Management Systems Society (HIMSS)...
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...
Highlights of the Advancing Interoperability and Improving Prior Authorization Processes Notice of Proposed Rulemaking (NPRM)
Reading and analyzing proposed rules is a necessary, albeit time consuming task. In order to help healthcare stakeholders, we’ve compiled some highlights of what is included in...
Don’t Delay! Prepare for CMS PA & Burden-Reduction Rule Now
The prior authorization process has long been a thorn in the proverbial side of healthcare. Providers, payers, and patients (perhaps most of all) have come to regard this...
What’s Up with the CMS Electronic Prior Authorization Regulation?
By Tony Schueth, MS, Point-of-Care Partners, CEO & Managing Partner
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