In a proposed rule published to the Federal Register on April 14, 2026, the Centers for Medicare and Medicaid Services (CMS) builds upon previous regulations finalized in 2020 and 2024 related to setting health information technology (HIT) standards to reduce the administrative burden of prior authorizations and other processes across payers.
While the bulk of the 2026 Interoperability and Prior Authorization for Drugs (CMS-0062-P) proposed rule would set standards for payers, such as Medicare Advantage (MA), it also begins to outline expectations for providers’ use of HIT to communicate with payers related to prior authorizations (PA) and submission of clinical or other documentation. There are also five requests for information related to various HIT issues.
LeadingAge will be reviewing the details of the proposed rule and share more analysis in the coming weeks.
Comments on the rule will be due 60 days after the proposed rule is published, approximately June 14, 2026.
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