On June 10, 2025, HAP asked CMS to enforce the Interoperability and Prior Authorization Final Rule (CMS-0057-F), citing 1.6 million Pennsylvanians in Medicare Advantage (54 percent of the state's Medicare beneficiaries).
On June 10, 2025, HAP told CMS Administrator Mehmet Oz it joins the AHA in asking CMS to enforce CMS-0057-F. Kate McCale, HAP vice president of compliance and regulatory affairs, signed for 235 institutions. HAP wrote that 54 percent of Medicare beneficiaries in Pennsylvania, or 1.6 million people, are in Medicare Advantage, and that MA enrollment in the state rose 60 percent over the last ten years. It said members face delays and extra documentation with MA organizations on authorization and payment. CMS's Jan. 17, 2024 fact sheet gives impacted payers until Jan. 1, 2027 for the FHIR APIs, including the Prior Authorization API. Decision clocks generally begin Jan. 1, 2026: 72 hours for expedited requests and seven calendar days for standard requests. The API requirements exclude drugs,
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