A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare ...

CMS has proposed a new rule to extend electronic prior authorization requirements to prescription drugs, aiming to speed approvals, improve transparency, and align standards across programs. 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 ...

Health insurers face a prior authorization prescription drug mandate similar to the rule imposed on claims, under a proposal released Friday by the Centers for Medicare & Medicaid Services. CMS is ...

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 ...

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 ...

Prior authorization has become one of the clearest points where administrative complexity directly affects patient care. For ...

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 ...