CMS Proposes Sweeping Expansion of Health Care Interoperability and Prior Authorization Requirements.

On April 10, 2026 (and officially published in the Federal Register on April 14, 2026), CMS published a proposed rule that would expand electronic prior authorization requirements, modernize HIPAA transaction standards, and strengthen Open Payments program enforcement. The proposed rule builds on the 2024 CMS Interoperability and Prior Authorization final rule and affects a broad range of regulated entities, including Medicare Advantage (MA) organizations, state Medicaid and Children's Health... By: King & Spalding