CMS's Prior Authorization Reform Rule Is Live. Here's What It Means.

Starting in 2026, CMS requires most payers to:

• - Respond to urgent PA requests within 72 hours
• - Respond to standard requests within 7 calendar days
• - Provide a specific reason for any denial
• - Support electronic PA through FHIR APIs

This is a significant win for practices drowning in PA paperwork — but it doesn't eliminate the burden. You still need to submit complete, well-documented requests to get fast approvals.

Start preparing your team now: better clinical documentation at the PA stage means faster turnaround under the new rules.