The US Department of Health and Human Services and the Centers for Medicare & Medicaid Services (CMS) is adding electronic prior authorization requirements to the Health Tech Ecosystem, the collaborative, standards-based initiative launched in 2025 to modernize healthcare data sharing between providers, payers, and patients. Health systems, hospitals, physician practices, electronic health record vendors, and digital health developers will participate in advancing electronic prior authorization.
As of January 1, 2027, electronic prior authorization interfaces will be required, and their use will eventually be incorporated into the Medicare Promoting Interoperability Program for hospitals and the Merit-based Incentive Payment System for clinicians.
“The current prior authorization process creates unnecessary delays for patients, burdens healthcare providers with excessive paperwork, and erodes trust between payers and healthcare providers, even though all share the same goal: delivering high-quality patient care,” said a blog post by CMS Administrator Mehmet Oz.
To learn more, visit the Electronic Prior Authorization page on the CMS website.
