Traditional MedicarePrior AuthMedium impact
2026-05-07 - Electronic Prior Authorization Improvements: Get Involved & Start Testing
Medicare/CMS·Prior Authorization
Effective date
Jul 1, 2026
We identified it
May 8, 2026
Summary
CMS is implementing electronic prior authorization improvements and encourages providers to begin testing FHIR API integration with EHR vendors and payers. A new Medicare GLP-1 Bridge demonstration starts July 1, 2026, requiring providers to submit prior authorization requests through a central processor for eligible GLP-1 medications.
Action Required
Immediately: Contact your EHR vendor to begin testing electronic prior authorization FHIR API integration with payer partners to identify gaps and validate workflows. By July 1, 2026: For Medicare patients needing GLP-1 medications, submit prior authorization requests through the new Medicare GLP-1 Bridge central processor (requests will not be processed before July 1). Visit the Electronic Prior Authorization webpage and Medicare GLP-1 Bridge webpage for implementation guidance.