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CMS Issues Proposed Rule on Prior Authorization Standards

On December 6, 2022, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services. CMS proposes to require certain payers to implement an electronic prior authorization process, shorten the time frames for certain payers to respond to prior authorization requests, and establish policies to improve the efficiency and transparency of the prior authorization process. AMIA will submit comments to the Agency by the March 13, 2023, deadline.

Industry News

Answering Workforce Challenges with Virtual Models of Care

Workforce shortages among health professionals have accelerated in the past few years and more leaders are considering virtual care workflows and technology to reduce nursing cognitive burden, frustration, and inefficiencies. Read our blog to learn how organizations are managing the resources they need to provide services while also supporting their frontline caregivers.

End-User Feedback Enhances Federal Electronic Health Record

In October, the Federal Electronic Health Record Modernization (FEHRM) office hosted the second Federal EHR Annual Summit. Over 700 end users from the Department of Defense, Department of Veterans Affairs, and the U.S. Coast Guard provided feedback for enhancing the federal EHR to better serve all beneficiaries. As we enter 2023, the FEHRM wishes happy holidays to all our partners in transforming health care delivery.


CMS Quality Data Implementation User Group

CMS recently announced the QDM User Group is expanding its scope and changing its name to accommodate the wider breadth of data models and standards available for expressing quality measures. CMS states that with the coming move to FHIR standards for quality measurement, the group has seen an increase in discussion around the use of various FHIR models, especially QI-Core. To accommodate these discussions and to increase implementer participation to address real-world data availability, CMS has updated the user group charter to allow for a wider scope of user group discussions. All changes will be effective on the February 15, 2023, QDI meeting. View the eCQI Resource Center to register for the meeting. 

NLM Success – Expanding Broad Discovery of Publicly Funded Research

The National Library of Medicine (NLM) recently announced the success of its pilot to expand discovery of publicly funded research results on preprints relating to the COVID-19 pandemic. Phase 1 of the preprint pilot was launched to test the viability of making preprints resulting from NIH-funded research searchable in PubMed Central (PMC) and, by extension, discoverable in PubMed. See information about Phase 2 of the pilot here.

OSTP Extends Deadline for Comment on Clinical Research Infrastructure and Emergency Clinical Trials RFI

The White House Office of Science and Technology Policy (OSTP) has extended the comment deadline until January 27, 2023, for responses to the Request for Information (RFI) on Clinical Research Infrastructure and Emergency Clinical Trials.

OIG Issues Report on Unimplemented Recommendations to Address Waste, Fraud and Abuse

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently issued its annual report on unimplemented recommendations to combat waste, fraud and abuse in HHS programs. Some of these recommendations include a focus on cybersecurity incident response, improved Medicaid data reporting by States, and improvements in Medicare Advantage Organization oversight of encounter records based on an ordering provider’s national provider identifier.

FDA Announces Updates in Digital Health Policy Navigator Webpage

Recently, the Food and Drug Administration (FDA) announced updates to improve access to the Digital Health Policy Navigator webpage and added examples to the clinical decision support software policy considerations in step 6 of the 7-step review of software functions.

FTC Updates Online Mobile Health Apps Tool

The Federal Trade Commission (FTC), in collaboration with the Office of the National Coordinator, FDA, and HHS Office of Civil Rights, announced an updated online Mobile Health Apps Tool, an interactive tool designed to guide mobile health app developers through the myriad of federal laws and regulations governing health, safety, and privacy.

NIH All of Us Research Program Returns Results

The National Institutes of Health (NIH) All of Us Research Program has begun to return personalized health-related DNA results to 155,000 program participants. Learn more here

Sequoia Project Releases “Data Usability Implementation Guide” 

The Sequoia Project recently announced the release of the "Data Usability Implementation Guide." The document offers guidance to improve the usability of data received by end users within their workflows to benefit patient care.

Legislation and Politics

As of this writing, members of Congress have not yet voted on FY 2023 appropriations to fully fund the federal government. A Continuing Resolution was passed to fund the government until December 23, giving lawmakers more time for negotiations on a funding package.

Around the Web

AMIA’s Washington Download is your source for health informatics policy news and information from around the Beltway, covering action from the Hill, the Administration and important AMIA collaborators.