Explore the CMS interoperability and prior authorization rule
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The CMS Interoperability and Prior Authorization rule mandates new health plan protocols. Key points include:
- Standard requests: 7-day completion by Jan 1, 2026, for Medicare Advantage, Medicaid, CHIP (excluding QHPs on the federally-facilitated exchange)
- Expedited requests: 72-hour completion
ZeOmega's HealthUnity Smart Authorization Gateway aids compliance with these regulations. It's designed for payer-provider cooperation and value-based care.
Discover how to ready your health plan for these CMS changes in this infographic.