CMS Interoperability and Prior Authorization Final Rule: What no one is thinking about but should be
This webinar was originally broadcast on October 15, 2024.
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Summary
This panel discussion explores the sweeping changes introduced by the CMS Interoperability and Prior Authorization Final Rule, focusing on both the practical and unforeseen implications for payers and providers. The rule promises to streamline prior authorization processes and enhance data exchange through new API mandates, but its implementation presents significant operational challenges. Payers must adapt to tighter decision timelines, increased transparency, and new technology requirements, while providers are tasked with improving data accessibility and reporting. Beyond the anticipated efficiencies, the discussion will delve into potential pitfalls, including the strain on IT infrastructure, the risk of data security issues, and the evolving nature of payer-provider relationships.
Join us as we unpack the complexities of this regulatory shift and discuss strategies for navigating the road ahead.
Speakers
Stephanie Ngo
Managing Director Payer Services
Tegria
Stephanie Ngo is a Managing Director of Payer Services, leading Payer-Provider Collaboration efforts at Tegria. She is a knowledgeable healthcare leader with 20 years of experience. She helps clients drive value by leveraging interoperability, streamlining data and workflows to support internal operations, population health, and value-based care initiatives.
Jon Kimerle
Director, Global Strategic Alliances
Pure Storage
Jon Kimerle serves as the Sr. Strategic Alliance Manager at Pure Storage where he is responsible for managing the relationship with Epic Systems and contributing on the healthcare solutions team with business development. Prior to joining Pure, he served in several senior IT leadership roles including Interim CIO, VP of IT Strategy and Planning, and VP of Clinical Transformation with SSM Health, a $8B Integrated Delivery Network in the Midwest. He has over 29 years of healthcare industry experience.
Jon holds both a BS in Health Administration and a Master of Health Administration (MHA) from the University of Missouri-Columbia. He is also an adjunct professor of healthcare IT management at several universities.
