Thursday, February 4, 2021

Has Biden Administration Deleted Trump's Prior Authorization Final Rule?

Update - I posted this blog about the deletion of the Prior Auth role on February 4 - the first trade press article I can find making the same point, is Fierce Healthcare on February 17.   See a Feb 28 article at Policy & Medicine that discusses the Prior Auth rule, and various comments, but doesn't remark on its deletion.

The Feb 28 article has a comment letter quote from AHIP - “This shabbily and hastily constructed rule puts a plane in the air before the wings are bolted on by requiring health insurance providers to build these technologies with incomplete and untested instruction manuals.” 



It's no secret that the Biden administration has deleted or delayed several of the later Trump administration CMS policies.

However, I haven't read anywhere else, formally, that the Prior Authorization Final Rule was being deleted, but it seems to have disappeared from the CMS website and even the press release for it on January 15, seems to have been deleted (!!).

See a Becker's Hospital Review article on January 26 that three rules were being deleted while others were moving forward.  Here.  Deletions, per Becker's were Medicare Part A enrollment rules, dialysis rules, oversight of accreditation rules.   However, Becker's said that the prior auth rule was moving forward, and that the MCIT rule (breakthrough coverage plus reasonable and necessary regulations) was going forward.

These can be distinguished.  All the press releases about the MCIT are still up, and the full rule officially appeared in the Federal Register on January 14.  Here.

But check out the links in my January 15 article about the Prior Auth rule.  They're all dead.  If you look at the CMS press release archive for January, the Prior Auth press release seems to have vanished.   And, the prior auth rule never appeared in the Federal Register, either.

This may not be new-news, but I googled it, and I couldn't find any press about the prior auth rule being deep-sixed.   But it seems it's as dead as Marley's ghost.

Since they may now be collector's items, I put the press release and fact sheet and Prior Auth Final Rule in a cloud zip file - here.

"As dead as Marley's ghost"



Separately, the Biden administration officially delayed the Trump drug pricing rule ("Most Favored Nation") for a year, but it's tied up in a pile of lawsuits anyway.  

By coincidence, an article in JAMA this week on America's outrageous healthcare administrative costs note that reform of prior auth required by Section 1104 of the ACA, never occurred.  By USC's Robert Kocher - here

AMA comments on the prior auth rule - here.

See an article that Biden "probably moving ahead" with prior auth rule - here.  See an article at Bloomberg about delays in rules here.