Electronic Prior Authorization
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. Read the full press release.
The content is for health care providers. If you’re a person with Medicare, visit Medicare.gov.
Use Electronic Prior Authorization for Reduced Burden & Better Patient Care
CMS, health plans, and certified electronic health record (EHR) vendors are working together to streamline the electronic prior authorization process for medical items and services. Estimates suggest requesting prior authorizations costs providers $20–50 per hour and takes an average of 13 hours per week. For each provider, that’s approximately $34,000 and 700 hours of administrative time each year that could otherwise be used to take care of patients.
We can’t do this without you! Act now to start submitting prior authorization requests electronically in 2027.
EHR vendors can implement standardized electronic prior authorization transactions. Starting January 1, 2027, certain health plans regulated by CMS must implement and maintain these Application Programming Interfaces (APIs), so it’s important to be ready:
