January 18, 2024
Statement attributed to:
Eric Musser, NCQA Assistant Vice President, Federal Affairs
“NCQA applauds Final Rule CMS-0057-F issued today. NCQA recognizes the role of prior authorization in decreasing unnecessary patient procedures and health care expenditures. While there are benefits, prior authorization can be a source of administrative burden on providers, interrupt physician workflows and negatively impact patient experience and access. Current prior authorization policies are based on administrative data and guidelines, and there is broad desire to align them more closely with clinical best practices and treatment guidelines. We believe that digitalizing prior authorization—much like the move to digital quality measures—can offer an opportunity to improve both patient and provider experience.”
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA Accredits and Certifies a wide range of health care organizations. It also Recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. In recognition for its leadership in diversity, equity and inclusion, NCQA has won the Excellence in Diversity Award from the Chesapeake Human Resources Association. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make informed health care choices. NCQA can also be found at Twitter @ncqa and on LinkedIn at linkedin.com/company/ncqa.