The Centers for Medicare & Medicaid Services continues to work tackling the challenges posed by health insurers that insist they will not pay for certain medical services unless they authorize those services beforehand.

In a new blog post, CMS Administrator Mehmet Oz reviews past, current, and future agency efforts to address the challenges posed by the need to obtain prior authorization for medical services.  The latest such step, he notes, is adding electronic prior authorization to the Health Tech Ecosystem.  Under this approach, work groups across the spectrum of stakeholders seek to align CMS Interoperability and Prior Authorization Final Rule deadlines and address workflow gaps and technical handoffs that no single sector alone can fix.

Meanwhile, CMS has been working with electronic health record (EHR) vendors to streamline and digitize the prior authorization process.

In addition, electronic prior authorization interfaces from Medicare Advantage, Medicaid, CHIP, and marketplace plans will go live on January 1, 2027.

Learn more, and find links to additional resources, from this CMS blog post and from theMcKnight’s Long-Term Care News article “CMS announces new effort to streamline prior authorizations.”