CMS: Early Adopters of E-Prior Authorizations Announced

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Electronic prior authorizations are coming to Medicare Advantage and other payers, but it remains unclear when the impacts and improvements will be felt by post-acute care providers.

The administrator of the Centers for Medicare and Medicaid Services Dr. Mehmet Oz announced on May 14, 2026, that the agency is accelerating efforts on electronic prior authorization-required under the 2024 Interoperability and Prior Authorization rule for specified health plans, including Medicare Advantage plans, to implement an application programming interface (API)-enabled data exchange by January 1, 2027-through a group of early adopters.

These early adopters include nine health systems and provider groups, nine health plans that signed a June 2025 pledge to reduce prior authorizations, and seven electronic health record companies; PointClickCare and MatrixCare are not among them. Electronic prior authorization refers to this API-enabled data exchange designed to streamline the prior authorization process.

The Electronic Prior Authorization Acceleration (EPAA) initiative seeks to address early implementation challenges and support readiness. The early adopters through this initiative are integrating the e-prior authorization into their clinical and administrative systems, reducing their need for faxing and portal-based submissions, increasing their visibility into authorization status and decisions, and essentially working out the kinks in workflows and the handoffs between systems. CMS encourages other health care and EHR organizations to join the EPAA initiative as it expands.

To date, this initiative appears focused on prior authorizations that originate from hospitals and physicians. LeadingAge will continue to advocate for post-acute providers to be included in these efforts to reduce the administrative burden of prior authorizations and the time required to receive a decision from the plans on these requests. More information on the CMS Health Tech Ecosystem can be found here.