Adhering to the deadline set by CMS for the new prior authorization rules is essential for ensuring compliance and avoiding penalties. By meeting the deadline, healthcare providers can streamline their processes, improve patient care, and maintain a positive reputation.
Stay on track with these important dates and milestones leading up to the deadline
CMS Interoperability and Patient Access final rule (85 FR 25510) established. Foundational policies that the new CMS rules will build upon.
Initial CMS Interoperability and Prior Authorization proposed rule (85 FR 82586) that was withdrawn, but the new proposed rule incorporates the feedback that was received from public commenters.
The CMS proposes Advancing Interoperability and Improving Prior Authorization Processes Rule (87 FR 76238). Currently the latest rule that looks to address Patient & Provider APIs, Payer-to-Payer data exchange (FHIR), & Prior Auth improvements.
If finalized, these prior authorization policies would take effect starting in 2026.
When the initial set of prior authorization metrics are required to be reported
publicly by posting them directly on the payer’s website or via publicly accessible hyperlink(s) on an annual basis.
Don't miss any of the key dates and milestones leading up to the deadline.
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