CMS Proposes Major Changes To Drug Prior Authorization Processes: What You Need To Know

On April 14, 2026, the Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule that would require faster prior authorization (“PA”) decisions, expand electronic PA to drugs, and increase transparency across federal health programs, with the goal of cutting long waiting periods and reducing barriers to timely access to critical treatments. The proposed rule was issued jointly by CMS and the Office of the National Coordinator for Health Information Technology and is designed... By: Sheppard, Mullin, Richter & Hampton LLP