WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services recently launched a new industry initiative aimed at accelerating adoption of electronic prior authorization systems ahead of federal interoperability requirements set to take effect in 2027.
The Electronic Prior Authorization Acceleration initiative brings together 29 healthcare organizations, including hospital systems, electronic health record vendors, physician groups, and digital health networks, as CMS seeks to reduce administrative burdens tied to insurance approvals for medical services.
The effort is part of CMS’ broader Health Tech Ecosystem initiative and comes as regulators push healthcare providers and insurers to replace manual authorization methods such as fax submissions and web portal workflows with standardized digital systems.
CMS Administrator Mehmet Oz described prior authorization delays and administrative complexity as systemic issues requiring coordination across the healthcare industry.
“Prior authorization won’t be fixed by technology alone,” Oz said in a statement. “It requires the entire healthcare system to work together to solve real-world challenges.”
Participating healthcare providers include Cleveland Clinic, Providence, Rush University System for Health, and Sanford Health.
Technology and electronic health record participants include Epic, Oracle, athenahealth, and eClinicalWorks.
Several major insurers had already joined a related CMS prior authorization pledge announced last year, including Cigna, Humana, UnitedHealthcare, and Elevance Health.
Under CMS interoperability rules finalized previously, certain health plans must support application programming interface-based data exchange using Fast Healthcare Interoperability Resources, or FHIR, standards by January 1, 2027.
The regulations also require payers to meet decision timeframes for prior authorization requests and publicly report metrics tied to authorization activity.
CMS indicated the new initiative is intended to address operational barriers that have slowed adoption of electronic prior authorization despite existing technical standards.
Participating organizations will work on integrating authorization tools into clinical systems, improving visibility into approval decisions, reducing manual processing, and addressing workflow gaps between providers, insurers, and technology platforms.
CMS stated additional healthcare organizations are expected to join the initiative as implementation efforts expand.
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