On Wednesday, January 17, 2024, the Biden administration finalized a rule to streamline Medicare Advantage, Medicaid, and other government-sponsored health plans’ use of prior authorization. This final rule will require government-sponsored health plans to have a faster response to prior authorization requests and to include rationale for denied requests.  

Having the government finally address prior authorization is a win; however, lawmakers must look at inappropriate denials as well as the time, labor, and the expense clinicians put into fighting health plans through appeals. Looking ahead, prior authorization, along with price transparency, will work together to reduce healthcare costs for patients and increase the clinician’s capability to perform high-quality services. 

To review the Zotec Partners Healthcare Advocacy Team's update on the prior authorization final rule, click here.