AMA urges CMS to “stay the course” on prior authorization reform
The AMA sent a letter (PDF) to CMS Administrator Mehmet Oz, MD, expressing the physician community’s concerns regarding implementation of the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F). The letter outlined how recent efforts by some health plans and vendors would undermine the vision of real-time, point-of-care prior authorization automation in favor of proprietary solutions.
Notably, the AMA highlighted to CMS a recent sign-on letter (PDF) from the AMA and 35 national medical specialty societies to the HL7 Da Vinci Project Steering Committee that urged rejection of recent proposals that would reduce transparency and standardization—two major wins for physicians in the CMS rule. The AMA urged CMS to issue clarifying sub-regulatory guidance that will ensure prior authorization technology meets CMS’s original regulatory intent by providing visibility into prior authorization requirements at the point of care and supporting a uniform, automated process that has the same “look and feel” across health plans. The AMA is also pressing payers and technology companies to move beyond dialogue and jointly deliver meaningful prior authorization reform.
More articles in this issue
- Nov. 21, 2025: Advocacy Update spotlight on the 2025 AMA Interim Meeting
- Nov. 21, 2025: Medicare Payment Reform Advocacy Update
- Nov. 21, 2025: State Advocacy Update
