CMS Announces Early Adopters to Advance Solutions for Electronic Prior Authorization, Accelerating Momentum Ahead of 2027 Requirements

CMS Announces Early Adopters to Advance Solutions for Electronic Prior Authorization, Accelerating Momentum Ahead of 2027 Requirements

The Centers for Medicare & Medicaid Services (CMS), through its Health Tech Ecosystem, is advancing its electronic prior authorization efforts through a newly established Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements.

30 healthcare organizations-including health systems, electronic health record developers, physician practices, networks, and digital health developers-have signed on as early adopters in this cross-sector effort. They join many of the nation's largest payers that have already committed to working with CMS to identify and address workflow, technical, and operational barriers that have slowed adoption of electronic prior authorization across the healthcare system.

"Prior authorization won't be fixed by technology alone. It requires the entire healthcare system to work together to solve real-world challenges," said CMS Administrator Dr. Mehmet Oz. "CMS continues to bring organizations together to do just that, and these early adopters are choosing to lead. This work will help reduce administrative burden, giving clinicians more time to focus on patients and helping people get care faster."

Early adopters in this next phase of CMS's broader effort to modernize healthcare through the Health Tech Ecosystem include:

• Providers: AtlantiCare, Bon Secours Mercy Health, Cleveland Clinic, Froedtert ThedaCare, Ochsner Health, Providence, Rush University System for Health, Sanford Health, Tennessee Oncology
• Electronic health records: athenahealth, eClinicalWorks, Epic, MEDITECH, Modernizing Medicine, Inc., Oracle, TrueBridge
• Networks: b.well Connected Health, CommonWell, eHealth Exchange, Kno2

These healthcare organizations are joining health plans that signed the landmark pledge last June, including:

• Aetna, Blue Shield of California, Cambia Health Solutions, Cigna, Elevance Health, Highmark Blue Shield, Horizon Blue Cross of Blue Shield of New Jersey, Humana, UnitedHealthcare

In a separate effort to increase access and use of electronic prior authorization, CMS established requirements in the CMS Interoperability and Prior Authorization final rule for certain impacted payers to support electronic prior authorization for medical items and services, including:

• API-enabled data exchange using FHIR-based standards
• Defined timeframes for prior authorization decisions
• Public transparency by requiring impacted payers to report prior authorization metrics
• Supporting industry readiness ahead of the January 1, 2027, deadline

In addition to CMS's rulemaking efforts, the Electronic Prior Authorization Acceleration initiative focuses on addressing implementation challenges and supporting readiness ahead of these requirements.

The early adopters of the initiative announced today are helping move the industry beyond technical readiness by working together to address how these capabilities function in practice across real-world workflows. Through this effort, participating organizations are working to:

• Integrate electronic prior authorization into clinical and administrative systems
• Reduce reliance on manual processes such as fax and portal-based workflows
• Increase visibility into authorization status and decisions
• Close workflow gaps and improve technical handoffs across systems

Meaningful progress requires alignment across the entire ecosystem-not isolated adoption within individual sectors.

The organizations announced today represent an initial group of early adopters, with additional participants expected as this initiative expands.

CMS encourages organizations across the healthcare system-including providers, technology developers, and network partners-to join this initiative and help accelerate progress toward a more efficient, transparent, and patient-centered prior authorization process.

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