The CMS 2026 Prior Authorization Rule, effective January 2026, mandates payers in Medicare Advantage, Medicaid, CHIP, and ACA markets to adopt FHIR-based APIs, electronic prior authorization, and ...
Prior authorization remains one of the most resource-intensive and provider-friction–heavy processes for health plans, further complicated by growing regulatory requirements under CMS-0057. As ...
Learn how investment in IT infrastructure mandated by CMS-0057 can be a catalyst for advancing health plan priorities and improving care. Ensuring your investment in IT infrastructure mandated by ...