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MHCC recommends prior‑authorization data reporting, EHR API adoption and continued monitoring
Summary
Maryland Health Care Commission presented findings and three recommendations on prior authorization: report prior‑authorization indicators to the all‑payer claims database, require EHR vendors to implement CMS‑aligned APIs for electronic prior authorization, and monitor impacts through 2028.
The Maryland Health Care Commission on Jan. 23 briefed the Senate Finance Committee on the study of health insurance prior authorization and proposed three recommendations to streamline electronic prior authorization and improve transparency.
MHCC staff said the recommendations respond to implementation realities and federal action. “The Centers for Medicare and Medicaid Services released … an interoperability and prior authorization final rule” on Jan. 17, 2024, MHCC noted, and Maryland should align state policy to reduce administrative burden and bring prior authorization into electronic health record workflows.
MHCC’s three…
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