2026-05-07 - Electronic Prior Authorization Improvements: Get Involved & Start Testing
AI Summary
CMS is implementing electronic prior authorization improvements and encourages providers to begin testing FHIR API integration with EHR vendors and payers. A new Medicare GLP-1 Bridge demonstration starts July 1, 2026, requiring providers to submit prior authorization requests through a central processor for eligible GLP-1 medications.
Action Required
Immediately: Contact your EHR vendor to begin testing electronic prior authorization FHIR API integration with payer partners to identify gaps and validate workflows. By July 1, 2026: For Medicare patients needing GLP-1 medications, submit prior authorization requests through the new Medicare GLP-1 Bridge central processor (requests will not be processed before July 1). Visit the Electronic Prior Authorization webpage and Medicare GLP-1 Bridge webpage for implementation guidance.
Plan Types
Traditional Medicare
Specialties
all-specialties