Healthcare Payer IT in 2026: Digital Prior Authorization, Enforceable Transparency, and Outcomes-Driven Platforms Spark a New Acquisition Race

CMS compliance deadlines and heightened cybersecurity expectations are accelerating payer interoperability and utilization management modernization while shifting vendor selection toward platforms ...
The American Journal of Managed Care

Survey Finds Slow Start on CMS Interoperability Rule Implementation

A large portion of payers and providers have not started or are partially through implementing CMS API requirements, with compliance due by January 1, 2027. Key challenges include funding, developing ...
Fierce Healthcare

HHS locks in health IT rule to advance electronic prior auth, real-time prescription benefit checks

The health IT arm of the Department of Health and Human Services finalized a rule this week that federal leaders say will remove red tape and enable faster prior authorization and real-time ...
Healthcare Finance News

Many payers, providers unprepared for interoperability and prior authorization rule, WEDI finds

Operational provisions take effect Jan. 1, 2026. Patient Access API and prior authorization decision timeframes and denial reason requirements take effect in 2026. Effective Jan. 1, 2026, impacted ...