news

FOR IMMEDIATE RELEASE: January 15, 2021

FOR MORE INFORMATION: Jeff Van Ness, (202) 204-7515, jvanness@communityplans.net

STATEMENT OF ACAP CEO MARGARET A. MURRAY ON FINAL PRIOR AUTHORIZATION RULE

WASHINGTON— Margaret A. Murray, Chief Executive Officer of the Association for Community Associated Plans (ACAP) released the following statement today on the “Reducing Provider and Patient Burden by Improving Prior Authorization Processes, and Promoting Patients’ Electronic Access to Health Information for Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-facilitated Exchanges” final rule, which will make significant changes to the prior authorization process.

“ACAP strongly urges HHS to change its mind and rescind the prior authorization final rule that they have rushed to the Federal Register so plans can give these substantial proposed changes adequate consideration.

“As we warned last year, this rule includes numerous new and complex policy changes—some of which ACAP supports— but CMS gave plans an absurdly short time period to consider and create strategies to implement these changes. 25 days is simply not enough, especially while our plans are prioritizing the ongoing COVID-19 pandemic and forthcoming vaccine distribution efforts.

“CMS states the intent of this rule is to reduce administrative burden for providers and ensure patients have access to their health information. These are worthy goals. But they are not feasible if plans have not been given sufficient time to prepare.

“HHS has rushed this rule at every step of the process and provided little more than lip service to the stakeholders who will be left to implement these sweeping changes. Without sufficient time to digest these changes, ACAP calls on the Biden Administration to freeze implementation of this regulation and for Congress to consider its recission by way of the Congressional Review Act.”

About ACAP:

ACAP represents 78 health plans, which collectively provide health coverage to more than 20 million people. Safety Net Health Plans serve their members through Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), the Marketplace and other publicly-sponsored health programs. For more information, visit www.communityplans.net.

# # #