On June 15, 2026, Aimed Alliance sent a letter to the Centers for Medicare & Medicaid Services (CMS), expressing support for proposed rule on prior authorization, which aims to modernize and standardize electronic prior authorization processes to reduce administrative burdens on providers and patients. While applauding the proposal to mandate electronic requirements across both pharmacy and medical benefits and improve the transparency of denial notices, the letter emphasizes the need to protect consumers from inequitable coverage practices. Specifically, Aimed Alliance urges CMS to clarify that the prior authorization process must be a singular, definitive determination of medical necessity, prohibiting health plans from forcing patients to seek substitute pathways for sourcing a medication through alternative funding programs as a prerequisite for coverage after a drug has already been deemed medically necessary.
Read the Aimed Alliance Comment CMS Prior Authorization Proposed Rule.
Last Updated on July 1, 2026 by Aimed Alliance
