WASHINGTON — The American Medical Association (AMA) has warned that recent and proposed changes issued by the Centers for Medicare & Medicaid Services (CMS) could force states to undertake costly information-technology and administrative overhauls on compressed timelines, raising concerns about implementation challenges across Medicaid and other federal health programs.
In comments submitted to CMS and in recent advocacy updates, the physician group said federal requirements tied to electronic prior authorization, reporting systems and other administrative changes should be phased in gradually to avoid creating new costs and operational burdens for hospitals, physicians and state agencies. The AMA urged CMS to allow transition periods before mandating widespread use of new electronic tools.
The concerns come as CMS advances a series of regulatory changes affecting Medicaid and Medicare programs. On May 20, the agency proposed new rules governing Medicaid state-directed payments and certain supplemental payment arrangements, describing the measures as part of an effort to improve fiscal oversight and align payment practices more closely with Medicare standards. CMS said the proposal would establish national standards and provide states time to adjust payment arrangements.
Separately, CMS has issued guidance and rulemaking related to Medicaid eligibility renewals and other program requirements that states must implement in the coming years. Agency officials have said the changes are intended to strengthen program integrity and improve accountability.
“The AMA’s first priority is making sure electronic prior authorization works in the real world before hospitals are required to rely on it,” the association said in comments summarized in its June 5 advocacy update. The group warned against requiring certified electronic systems before the technology is widely available and fully deployed.
CMS has defended its broader regulatory agenda as necessary to reduce waste, improve transparency and ensure taxpayer funds are used appropriately. In announcing its Medicaid payment proposal, the agency said it was seeking public comment and planned a transition period to allow states and providers to adapt. CMS Administrator Dr. Mehmet Oz said the goal was to protect Medicaid’s long-term sustainability while improving accountability.
Hospital and provider organizations have also been reviewing the potential effects of the proposals. The American Hospital Association said CMS’ Medicaid payment rule would modify policies governing state-directed payments and establish new requirements for some supplemental payments.
As of Thursday, CMS was continuing to accept feedback on several pending proposals, while physician and hospital groups maintained calls for longer implementation timelines and additional guidance before new requirements take effect.
