CMS Interoperability and Prior Authorization Final Rule: A Compliance Reality Check for Payers and Providers
Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule, effective January 1, 2026, establishes new, enforceable standards for prior authorization and data sharing. It is intended to reduce administrative burden, improve transparency, and modernize data exchange across healthcare. But for many payers and providers, the reality of compliance is proving more complex than anticipated. As highlighted in a recent Healthcare Finance News article, organizations are facing significant challenges meeting the rule’s…
