A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare Advantage prior authorization requests for medications to 24 hours and ...

In 2026, federal policy changes are reshaping prior authorization by requiring faster insurer responses, expanded drug coverage rules, and public reporting of approval and denial rates. Medicare ...

CMS has proposed a 2026 rule expanding prior authorization reforms to include drugs under both medical and pharmacy benefits, introducing electronic workflows, faster decision timelines, and greater ...

Availity®, the nation’s largest health information network, reinforced its preparedness for the Centers for Medicare and Medicaid Interoperability and Prior Authorization Final Rule (CMS-0057-F) and ...

Health data company Smile Digital Health and MCG Health are partnering in a move that will help payers meet the requirements of the Centers for Medicare and Medicaid Services Interoperability and ...

CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...

While The CMS Interoperability and Prior Authorization Final Rule promises to streamline prior authorizations and increase payer accountability, will providers be prepared for the 2027 deadline? The ...

Prior authorization forces doctors to spend 13 hours a week fighting insurers. New federal rules are changing that. Here's what you need to know.

On April 14, 2026, the Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule that would require faster ...