Data / Federal rules / 2024-00895
Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges, Merit-Based Incentive Payment System (MIPS) Eligible Clinicians, and Eligible Hospitals and Critical Access Hospitals in the Medicare Promoting Interoperability Program
The Centers for Medicare & Medicaid Services published this final rule in the Federal Register on February 8, 2024. It took effect on April 8, 2024.
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What the agency says
This final rule will improve the electronic exchange of health care data and streamline processes related to prior authorization through new requirements for Medicare Advantage (MA) organizations, state Medicaid fee-for-service (FFS) programs, state Children's Health Insurance Program (CHIP) FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs). This final rule will also add new measures for eligible hospitals and critical access hospitals (CAHs) to report under the Medicare Promoting Interoperability Program and for MIPS eligible clinicians to report under the Promoting Interoperability performance category of the Merit-based Incentive Payment System (MIPS). These policies, taken together, will reduce overall payer and provider burden and improve patient access to health information while continuing CMS's drive toward interoperability in the health care market.
Key facts
- Document number
- 2024-00895
- Type
- Final rule
- Action
- Final rule
- Agency
- Health and Human Services Department; Centers for Medicare & Medicaid Services
- Published
- February 8, 2024
- Takes effect
- April 8, 2024
- Dates
- These regulations are effective on April 8, 2024.
- Docket
- CMS-0057-F
- Regulation ID (RIN)
- 0938-AU87
- Code of Federal Regulations
- 42 CFR 422; 42 CFR 431; 42 CFR 435; 42 CFR 438; 42 CFR 440; 42 CFR 457; 45 CFR 156
- Topics
- Administrative practice and procedure; Advertising; Aid to Families with Dependent Children; Brokers; Consumer protection; Grant programs-health; Health care; Health facilities; Health insurance; Health maintenance organizations (HMO); Health records; Hospitals; Indians; Individuals with disabilities; Intergovernmental relations; Loan programs-health; Medicaid; Medicare; Organization and functions (Government agencies); Penalties; Prescription drugs; Privacy; Public assistance programs; Reporting and recordkeeping requirements; Supplemental Security Income (SSI); Technical assistance; Wages; Women; Youth
- Significant
- Yes, under Executive Order 12866
- Pages
- 231
Other documents from the Centers for Medicare & Medicaid Services
Everything from the Centers for Medicare & Medicaid Services · Rules on administrative practice and procedure · Rules on advertising · Rules on aid to families with dependent children · Published in February 2024
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