Delaware First State to Use RHTP Funds for Prior Authorization Reform — $50M Digital System; Now Confirmed with $157M CMS Initiative
Key Questions
How is Delaware using RHTP funds?
Delaware is the first state to allocate $50M of RHTP funds specifically for prior authorization reform by building a digital system to standardize claims reviews.
What is the total funding amount for Delaware’s initiative?
The effort is confirmed as part of a $157M CMS-funded initiative that leverages the Delaware Health Information Network and Smart Health Network.
Why is Delaware’s approach significant?
This represents a novel use of RHTP funds beyond traditional infrastructure or workforce projects and may serve as a model for other states.
Delaware is the first state to explicitly use RHTP funds for prior authorization reform, allocating $50M to build a digital system to standardize claims reviews. This novel use case signals a new category of RHTP application beyond infrastructure or workforce. Now confirmed with $157M CMS-funded initiative leveraging DHIN and Smart Health Network. Implementation specifics available. No deadline yet, but it sets a model for other states.