◆ Hospital outpatient departments with “affirmation” rates of 90% or better in the prior authorization process for outpatient procedures will be “exempt from submitting prior authorization requests for dates of service beginning May 1, 2021,” CMS said in updated answers to frequently asked questions^[1] on the hospital outpatient prior authorization process. Their Medicare administrative contractors (MACs) will send hospitals a notice of exemption in the mail or through the MAC provider portal. Not only are the hospitals with a 90% compliance rate off the hook for the five procedures subject to prior authorization, but they’re exempt for two procedures that join the prior authorization process in July, said Ronald Hirsch, M.D., vice president of R1 RCM. “This is quite surprising in that these two procedures are not cosmetic-like, as with the other procedures, and the reimbursement is markedly higher,” he said. “But hospitals would be wise to be sure to obtain all the required documentation as if prior authorization was needed since these surgeries will be subject to biannual chart audits.”