Course: Proposed Rule on Profits and Related Basis Adjustments based on this document from the Federal Register: https://www.govinfo.gov/content/pkg/FR-2024-12-02/pdf/2024-27227.pdf This document contains proposed regulations regarding previously taxed earnings and...
Advancing Health Data Interoperability and Prior Authorization in Medicare and Medicaid
This comprehensive course targets the latest CMS regulations improving electronic health data exchange and streamlining prior authorization for Medicare Advantage, Medicaid, CHIP, and more. Participants will gain critical insights into the new API requirements that enhance patient data accessibility and reduce administrative burdens. Ideal for healthcare professionals and organizations aiming to meet compliance and leverage interoperability for better patient outcomes.
In this course you will learn the following:
* Understand the background and purpose of the rule.
* Identify key requirements for Patient Access, Provider Access, Payer-to-Payer, and Prior Authorization APIs.
* Learn about prior authorization process improvements, including timelines and denial justifications.
* Understand compliance requirements, timelines, and consequences of non-compliance.
* Recognize the impact of the rule on different stakeholders.
* Identify available resources for implementation and compliance.
Additional information
| Federal Register Title | 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. Document Number: 2024-00895 |
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| Course SKU | FR-24-674-1 |
| Why This Course Is Important | Without this course, healthcare professionals may struggle to adapt to new regulatory requirements, potentially facing increased administrative burdens and delayed patient care. |