Medicare & Medicaid Programs; Patient Protection & Affordable Care Act; Advancing Interoperability & Improving Prior Authorization Processes For Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children’s Health Insurance Program (CHIP) Agencies & CHIP Managed Care Entities, Issuers Of Qualified Health Plans On The Federally-Facilitated Exchanges, Merit-Based Incentive Payment System (MIPS) Eligible Clinicians & Eligible Hospitals & Critical Access Hospitals In The Medicare Promoting Interoperability Program

On December 14, 2022, the Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS) published this proposed rule that would place new requirements on Medicare Advantage (MA) organizations, state Medicaid fee-for-service (FFS) programs, state CHIP FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated  Exchanges (FFEs) to improve the electronic exchange of health care data and streamline processes related to prior authorization, while continuing CMS’ drive toward interoperability in the health care market. This proposed rule would also add a new measure . . .