ONC and CMS Launch Electronic Prior Authorization Testing Initiative Ahead of 2027 FHIR Mandates
The Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS) have jointly initiated a nationwide industry testing program for electronic prior authorization (ePA) workflows. This initiative involves 10-to-12-week testing sprints designed to validate end-to-end ePA processes in production-like environments. The program brings together health plans, hospitals, clinical providers, electronic health record (EHR) developers, and clearinghouse intermediaries. The goal is to identify and address technical and operational gaps before the federal requirements for ePA take effect in 2027. Testing focuses on high-volume clinical services using HL7® FHIR® Da Vinci implementation guides for Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR), and Prior Authorization Support (PAS). This collaborative effort aims to ensure smooth and efficient electronic prior authorization processes across the healthcare industry.
