The U.S. Centers for Medicare & Medicaid Services has issued three separate rules aimed at improving prior authorization processes. Among the three rules, one stands out: a proposed rule that would yield significant improvements in transparency and could dramatically streamline the prior authorization process across multiple plans that involve federal funds.
APTA is making a concerted advocacy push to ensure the rules are refined and finalized, in the face of opposing payer organizations and other stakeholders who want to see these rules disappear.
CMS needs individualized feedback highlighting the immense challenge and damaging impact prior authorization has on providers and their patients. To help lighten the lift, APTA created a comment writing tool to assist in the letter-writing process, as well as resources and guidance on how to write a comment letter to CMS. (Hint: It's easier than you think — but don't miss the March 13 deadline.)
So what does an effective letter look like? Let's take a close look at an actual letter drafted by an association member who used the APTA resources to create a letter that will really hit home with CMS.