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 ...

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 ...

CMS has proposed a 2026 rule to extend electronic prior authorization and interoperability requirements to prescription drugs under Medicare Advantage, Medicaid, CHIP, and ACA exchange plans. The ...

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 ...

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 ...

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 ...

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.

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 ...