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Regulatory

72-Hour Rule

The CMS-mandated maximum turnaround time for expedited (urgent) prior authorization decisions under CMS-0057-F.

What it means

This applies specifically to urgent requests where a delay could seriously jeopardize a patient's health. It's one of the two turnaround benchmarks (alongside the 7-day standard rule) that impacted payers must now meet, replacing what was previously a much less standardized timeline across different plans.