MACPAC conducted a literature review, a federal policy review, and stakeholder interviews on the role of automation in the Medicaid prior authorization (PA) process. During this session, we reviewed findings and challenges that surfaced in this research, including the extent to which automation is already in use in Medicaid PA; the availability of information and documentation about implementation and use of automation; the current state and federal policy landscape specific to automation in PA; and the potential risks posed by its adoption. In this session, we presented draft policy options for Commission consideration.
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Medicaid and CHIP Payment and Access Commission