New Prior Authorization Proposals: Implications for Prescription Drug Access

About this episode

The episode discusses recent federal actions on prior authorization and their implications for prescription drug access.

Health Affairs Publishing 's Jeff Byers welcomes Senior Editor Michael Gerber back to the pod to discuss recent federal action on prior authorization , including CMS’s proposal to expand response-time requirements to prescription drugs. The conversation also covers insurer efforts to reduce prior auth volume, the promise of AI and prior authorization, and what increased transparency could reveal about costs. To learn more, check out our recent Insider trend report on the current prior authorization landscape . And if you haven't already, join Insider today to get access to exclusive events, newsletters, cheat sheets, and reports. Related Links: CMS proposes new deadlines for prior authorizations for drugs ( Healthcare Dive ) 2026 CMS Interoperability Standards and Prior Authorization for Drugs Proposed Rule ( CMS ) A Rule by the Centers for Medicare & Medicaid Services on 02/08/2024 ( Federal Register ) Health Plans Reduce Prior Authorization, Support Continuity of Care and Enhanced Consumer Communications ( Blue Cross Blue Shield ) AI speeds up prior auth, coding while driving higher costs for health systems: PHTI report ( Fierce Healthcare ) Sign up for our free Health…

People in this episode

Host: Jeff Byers

Guest: Michael Gerber

Topics covered

• prior authorization
• prescription drug access
• health policy
• CMS proposals
• AI in healthcare
• transparency in costs

Keywords

• prior authorization
• CMS
• prescription drugs
• health insurance
• AI
• transparency
• health policy

Mentioned in this episode

Organizations: CMS, Blue Cross Blue Shield, Health Affairs Publishing, Fierce Healthcare, Healthcare Dive, Federal Register

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