The CMS-0057 rule regulates health plans, not practices, but administrators are the ones who have to get the EHR and billing vendor conversations right.
Blog|Articles|September 8, 2026
Prior authorization's biggest deadline is four months out. It isn't yours.
Author(s)Keith A. Reynolds
Fact checked by: Chris Mazzolini
Payers must turn on four prior authorization APIs by Jan. 1. Practices have no deadline, which is why most will get nothing from it.
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Health plans covered by the federal interoperability rule have until Jan. 1 to put four standardized data connections into production. Medical practices have no deadline, no penalty and no compliance obligation of their own. That is exactly why so many of them will get nothing out of it.
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