CMS Proposes Electronic Prior Authorization Incentives in Medicare Fee Schedule

CMS released a proposed rule on July 14, 2026, to incentivize electronic prior authorization through the Medicare Physician Fee Schedule for CY 2027. The proposal targets Medicare Ambulatory Specialty Models and the Merit-based Incentive Payment System, building on existing prior authorization requirements for health plans. The rule focuses on provider-side incentives rather than plan mandates. Comment periods and effective dates were not specified in the excerpt.

Managed Care