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AMA, ONC and CMS back free crosswalk and tools to make electronic prior authorization real
Summary
Officials said the ecosystem has delivered an endpoint directory, a SNOMED-to-CPT crosswalk (licensed for free by the AMA), and testing tools—elements they say are needed to scale electronic prior authorization and reduce administrative waste.
Tom Keene and CMS leaders described the electronic prior authorization pledge as an example of how the ecosystem produces operational results. Keene said three practical pieces were required: an endpoint directory ("Check. CMS produced it."), a SNOMED-to-CPT crosswalk ("Check. The AMA produced it and is licensing it for free."), and testing tools.
Keene and other speakers argued that those pieces allow the technology to work in the real world and could substantially reduce administrative waste. Keene cited nearly "$2,000,000,000 in administrative waste that prior authorization drains from the system every single year" and argued building the infrastructure and standards—rather than only mandates—will deliver savings and speed patient care.
Speakers urged payers, EHR vendors and providers to use the tools and said the administration is prepared to use regulation if voluntary progress stalls. The remarks positioned prior-authorization automation as both a technical and payment-reform problem.
