03/13/2023

Electronic Prior Authorization Processes Must Be Expedited and Include Cancer Drug Treatments

The Association for Clinical Oncology (ASCO) submitted comments in response to the Centers for Medicare & Medicaid Services (CMS) “Interoperability and Prior Authorization for MA organizations, Medicaid and CHIP Managed Care and State Agencies, FFE QHP Issuers, MIPS Eligible Clinicians, Eligible Hospitals and CAHs” proposed rule. The intent of the proposal is to streamline prior authorization by requiring Medicare Advantage plans, Medicaid plans, and Qualified Health Plans (QHP) on Federally Facilitated Exchanges (FFEs) to establish an electronic prior authorization process that would be integrated into a provider’s workflow.

ASCO commends CMS for taking steps to improve the prior authorization process and believes that, when combined with the recommendations in ASCO’s comments, the proposed reforms will improve beneficiary access to necessary and life-saving services and help ease the administrative burden on physicians.

While ASCO supports the proposed provisions that streamline prior authorization, the Association strongly urges CMS to address two overarching concerns with the proposed rule.

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