Payers publicly disclose PA requirements for 14% of services. Most automation skips right past that problem. EHR integration is where the rest of it falls apart.

CMS proposed extending electronic PA to drugs for the first time. Fifty health plans committed to standardized submissions by January 2027. The compliance window is getting shorter.

Payer PA data is public for the first time. Gartner defined intelligent PA as a market category. CMS dropped two final rules and a major proposed rule. Three weeks, a lot of ground covered.

MA insurers processed 53 million prior auth determinations in 2024. The March 31 compliance deadline arrives with more than half of those transactions still running on manual workflows.

AI in prior authorization has been promised for years. 2026 is the year the industry starts asking whether it actually works.

With CMS deadlines roughly 12 months out, health systems are done evaluating. They need solutions that work now, inside the workflows they already have.

AI pilots are turning into production systems. The organizations moving fastest are the ones that built for auditability and workflow integration from the start.

AI is moving fast in healthcare. The organizations pulling ahead are the ones embedding it where the work actually happens.

Real-time PA approvals are now a federal goal. The infrastructure to get there is taking shape. The gap between the two is where most organizations are stuck.

Payers have pledged to reduce prior auth delays. Providers aren't convinced. The data backs their skepticism.

A new WEDI survey shows 43% of payers haven't started CMS-0057-F prep. With January 2027 approaching, here's what's holding them back.

CMS-0057-F isn't just about faster prior auth — it's pushing for real interoperability, public accountability, and system-level infrastructure changes starting in 2026.

23 states have enacted PA reform laws, and more are on the way. As AI regulation in healthcare accelerates, the rules around prior authorization are changing fast. Here's what we're tracking.

As CMS-0057-F pushes for faster prior auth processes, payers and providers need to adapt. We break down the latest industry stats and how automation is cutting processing times from 20+ minutes to under 4 seconds.