March 13, 2023 – Vizient recently submitted comments on the Centers for Medicare & Medicaid Services’ (CMS) proposed rule to improve prior authorization processes for various plans and payers, including Medicare Advantage (MA) organizations and Medicaid managed care plans. Vizient applauded CMS for utilizing stakeholder feedback, including input Vizient shared in August 2022, to develop the proposed rule.
Vizient offered recommendations to the agency related to efforts to streamline PA processes and advance interoperability. For example, Vizient encouraged CMS to consider additional policies to ensure payers comply with the proposed rule, if finalized. Vizient also recommended CMS shorten the proposed timeframes in which a prior authorization decision would need to be made.
“Current prior authorization processes pose significant burden to providers and, more importantly, impede patient access to needed treatments,” said Shoshana Krilow, senior vice president of public policy and government relations for Vizient. “Vizient appreciates CMS’s proposals to streamline prior authorization processes and improve access to information but encourages the agency to prioritize providers’ perspectives as it finalizes the regulation.”
Additionally, Vizient responded to a request for information regarding health equity that was included in the proposed rule. Vizient provided recommendations related to social risk factor data exchange and noted one of the key challenges to collecting such data is a lack of consistency and standardization. Vizient also encouraged the agency to support implementation of provisions from the Consolidated Appropriations Act, 2023, which would help support the infrastructure needed to collect and share social risk factor data.
Last month, Vizient also shared feedback with CMS in response to the contract year 2024 Medicare Advantage and Part D proposed rule. Vizient provided recommendations related to utilization management tools including PA, marketing and health equity in our comments to the agency. Vizient appreciates CMS’s collaborative engagement with stakeholders to help promote equity in coverage and care.