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  • Stakeholders And Prior Authorization Programs
  • Post author
    Lacy Gaskins

Stakeholders And Prior Authorization Programs

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) sufficiently educate stakeholders about prior authorization programs, where CMS provides provisional affirmation of coverage before the claim is submitted or the medical service is provided. Requirements for contractors include holding training sessions, providing timeline information and other information on prior authorization programs, and assessing prior authorization submissions for completeness.

Full Transmittal: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R698PI.pdf

Subject: The Process of Prior Authorization

Number: 698

Title: Change Request 9940

Release Date: Jan. 20, 2017

Effective Date: Feb. 21, 2017

Implementation Date: Feb. 21, 2017

Special Notes: N/A

 

  • Post author
    Lacy Gaskins

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