Payer progress on CMS’ prior authorization final rule: 5 notes

Becker's Healthcare December 22, 2025
Elizabeth Casolo

Payers still have a ways to go in meeting their goals ahead of CMS’ Advancing Interoperability and Improving Prior Authorization Final Rule, according to a survey from the Workgroup for Electronic Data Interchange.

WEDI advises HHS on health IT. CMS’ final rule will require insurers to implement an application programming interface and report prior authorization metrics. The workgroup gathered insights from payers in October, which followed a survey from earlier this year, to better understand progress toward compliance.

Here are five things to know from the payer survey:

1. One-third of payers have not started their application programming interface requirements, down from 42% in...

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