CMS names 29 early adopters of electronic prior authorization ahead of 2027 deadline

WASHINGTON —

The Centers for Medicare and Medicaid Services on May 13 named 29 organizations as early adopters of its electronic prior-authorization initiative, the agency said. The group includes nine major insurers, among them UnitedHealthcare, Cigna, and Aetna, alongside health systems including Cleveland Clinic, Providence, Sanford Health, and Ochsner; EHR vendors Epic, Oracle, and athenahealth; and data networks eHealth Exchange and b.well Connected Health.

The signatories agreed to integrate electronic prior authorization into clinical and administrative systems, cut reliance on faxes and payer portals, surface authorization status to providers in real time, and improve technical handoffs between payer and provider systems.

CMS is moving ahead of a January 1, 2027 deadline under the Interoperability and Prior Authorization final rule, which requires payers in Medicare Advantage, Medicaid, CHIP, and ACA marketplace plans to support electronic prior-authorization APIs.

For floor staff, prior authorization remains one of the largest sources of administrative friction in hospital and clinic workflows, particularly around discharge planning, imaging, and specialty drugs. The American Hospital Association said the program could ease that burden if the early adopters deliver, though it stopped short of endorsing the technical approach.

Sources: CMS Newsroom · AHA News