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Prior Authorization Reform: 2025 Could Be A Year Of Changes

 
• By Laura Helbling

Prior authorization reforms could emerge as an important under-the-radar area of drug policy next year. An upcoming Medicare proposed rule, the extraordinary uptake of weight loss therapies, and the launch of the overhauled Part D benefit design will all drive attention to the issue.

Prior authorization
CMS wants to streamline prior authorization for drugs in Medicare and ACA exchange plans. • Source: Shutterstock

An upcoming proposed rule from the US Centers for Medicare and Medicaid Services could kick off an eventful period of reforms to the prior authorization process for prescription drugs in the US.

CMS is developing a proposed rule to “streamline” the prior authorization process in federal Medicare Advantage and Affordable Care Act...

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