CMS Accelerates Efforts To Support Health System-Wide Electronic Prior Authorization

The Centers for Medicare & Medicaid Services (CMS) is launching an Electronic Prior Authorization Acceleration initiative to support industry-wide implementation of electronic prior authorization data exchange by January 1, 2027, as required under the 2024 Interoperability and Prior Authorization Rule. The rule requires specified health plans, including Medicare Advantage plans, to implement API-enabled prior authorization data exchange. CMS said meaningful progress requires alignment across the health care ecosystem, rather than isolated adoption within individual sectors.

The initiative includes a group of early adopters—nine health systems and provider organization groups, seven electronic health record vendors, and four digital . . .