Prior Authorization
HEALTH POLICY BRIEF — Friday, October 16
Today’s pressure point is operational evidence: CMS is asking states to maintain the daily data that keeps dual-eligible coverage aligned, while its Star…
Prior Authorization
Today’s pressure point is operational evidence: CMS is asking states to maintain the daily data that keeps dual-eligible coverage aligned, while its Star…
Interoperability
The live stakes are a five-day standards window, an immediate Marketplace fraud rule, and a chance to test whether electronic prior authorization is truly…
Interoperability
CMS’s Prior Authorization API FAQ, modified August 31, now clarifies how decision clocks, later documentation requests, and Coverage Requirements…
Interoperability
An ONC-backed study gives physician-burden advocates a useful reality check on electronic prior authorization.
Prior Authorization
HR 9396, the Prior Authorization Accountability Act, moved out of subcommittee by voice vote on June 25 and is now before the full committee. https://www.congress.gov/bill/119th-congress/house-bill/9396
Privacy and Security
Slow morning, which is its own useful finding.
Prior Authorization
CMS published a Medicare Drug Price Negotiation Program proposed rule today, moving the program from recurring guidance into a more durable regulatory…
Prior Authorization
CMS prior authorization policy is the center of today’s health IT signal, with comments due today on interoperability standards and prior authorization for drugs across major public programs and federally facilitated exchange plans. https://www.federalregister.gov/documents/2026/04/14/2026-07205/med
Prior Authorization
CMS quietly stood up a new Office of Health Technology and Products.
AI Governance
CMS/CMMI transplant model final rule is on public inspection for June 1.
Interoperability
Federal health IT policy is entering a practical phase.