The Centers for Medicare & Medicaid Services May 13 announced 29 health care organizations have pledged early participation in its electronic prior authorization initiative. CMS said the organizations include health systems, electronic health record developers, physician practices, networks and digital health developers. The initiative is part of CMS’ Health Technology Ecosystem. The project will involve organizations aligning on the agency’s interoperability and prior authorization final rule deadlines, as well as efforts to address workflow gaps and technical handoffs. Electronic prior authorization interfaces for impacted payers will be required across Medicare Advantage, Medicaid, Children’s Health Insurance Program and Health Insurance Marketplace plans on Jan. 1, 2027.

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An AHA blog published July 28 highlights new electronic prior authorization requirements that begin Jan. 1, 2027, as a result of the Centers for Medicare…
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As major provisions of the 2024 Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization final rule take effect next year,…
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Americans experience healthcare affordability in different ways. Often, affordability is first considered in terms of health insurance premiums that fit within…
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The AHA provided comments June 15 to the Centers for Medicare & Medicaid Services on its proposed rule establishing electronic standards for drug prior…
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The Medicaid and CHIP Payment and Access Commission June 15 released its June 2026 report to Congress. Among the topics discussed, chapter two focuses on…
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A majority of physicians say the prior authorization process continues to negatively impact patient outcomes and employee productivity, according to a survey…