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HHS/CMS RIN: 0938-AV44 Publication ID: Spring 2024 
Title: ●Interoperability Standards and Prior Authorization for Drugs (CMS-0062) 
Abstract:

This rule CMS would propose new requirements for Medicare Advantage (MA) organizations and Qualified Health Plans (QHPs) offered on the Federally-facilitated Exchanges (FFEs) to streamline processes for the prior authorization for certain drugs.  We are developing this rule, in part, based on the significant number of public commenters who responded to the CMS Interoperability and Prior Authorization proposed rule (87 FR 76238) urging CMS to expand the proposed prior authorization policies to include drugs.

 
Agency: Department of Health and Human Services(HHS)  Priority: Section 3(f)(1) Significant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Undetermined  Unfunded Mandates: No 
CFR Citation: 42 CFR 422    42 CFR 431    42 CFR 438    42 CFR 457    45 CFR 156   
Legal Authority: 42 U.S.C. 1395hh   
Legal Deadline:  None
Timetable:
Action Date FR Cite
NPRM  11/00/2024 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: Federal, State 
Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Alexandra Mugge
Director & Chief Health Informatics Officer, Health Informatics and Interoperability Group
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Office of Burden Reduction and Health Informatics, MS: C5-02-00, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-4457
Email: alexandra.mugge@cms.hhs.gov