Is Blue Cross NC required to make real-time decisions on prior authorization requests when submitted through the Prior Authorization API?

The CMS 0057 Final Rule does not require impacted payers including Blue Cross NC to use the Prior Authorization API to make real-time decisions on prior authorization requests, but the automation that the API provides could improve decision timeframes. Though we anticipate that some responses or decisions may be made in real-time, other decisions will continue to necessitate review and evaluation by clinical reviewers. Blue Cross NC will make all prior authorization decisions in accordance with any timeframes required by law.