Health IT Policy Is Moving Back Toward Implementation

#Health IT Policy, Federal Rulemaking, Interoperability, Administrative Simplification

Federal health IT policy is entering a practical phase. The big question is no longer whether health care should become more digital, interoperable, or automated. The harder question is whether federal agencies can make the system work in the real world without shifting new burdens onto physicians and patients.

One current example is CMS’s 2026 Interoperability Standards and Prior Authorization for Drugs proposed rule. CMS is building on its earlier interoperability and prior authorization rules by proposing to extend electronic prior authorization requirements to drugs, shorten decision timelines, increase transparency, and require reporting on interoperability API endpoints and API usage metrics. The proposal is open for public comment until June 15, 2026. (CMS)

At the same time, ONC has been reconsidering the scope of federal health IT certification through the HTI-5 proposed rule. That proposal aims to reduce burden on health IT developers, revise information blocking-related definitions, and establish a foundation for AI-enabled interoperability and future FHIR-based API requirements. (ONC Health IT)

Taken together, these developments show where the federal conversation is headed. Agencies are trying to push interoperability from policy aspiration into operational infrastructure. That means more attention to APIs, standards, certification, reporting, prior authorization workflows, and the technical plumbing behind health care administration.

That shift matters. Better digital infrastructure could reduce administrative burden, improve transparency, and give clinicians and patients faster access to information. But poor implementation could do the opposite: create brittle APIs, more reporting obligations, vendor confusion, payer workarounds, and new compliance risk for physician practices.

The next phase of health IT policy should be judged by a simple test: does it make care delivery easier, safer, and more reliable at the point of use?

That is the signal worth watching.