Skip to main content

The U.S. Centers for Medicare & Medicaid Services has proposed new requirements that would ease some of the administrative burdens of prior authorization across a range of federal programs including Medicare Advantage, state Medicaid and Children's Health Insurance Program fee-for-service plans, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan issuers in the federal ACA insurance exchange. Those changes, if adopted, would make life easier for providers, including PTs, almost immediately after their 2024 startup date.

But it’s broader than that. The proposed rules provide several opportunities for a more expansive conversation around prior authorization, transparency, and other aspects of administrative burden. That's yet another reason why it's crucial for APTA members and supporters to send comment letters to CMS by March 13.

Here are five ways the proposed rules — and even the comment process — could help the profession gain ground in other longer-term, big picture areas.

Log in or create a free account to keep reading.

Join APTA to get unlimited access to content.

You Might Also Like...


Final MA Rule Solidifies Prior Authorization Wins

Apr 27, 2023

The APTA-supported provisions announced by CMS will help reduce administrative burden and ensure consistency across MA plans.


Members-Only Payment Advocacy Resource Collection Grows

Mar 21, 2023

The resource center, created by APTA and APTA Private Practice, now offers information on MPPR, the PTA differential, and more.


Advocacy in Action: Prior Authorization Comment Letters from Members, Part 3

Mar 6, 2023

We're sharing real-world examples of what makes for a great comment letter. This installment: an APTA payment chair's perspective.