The Centers for Medicare & Medicaid Services (CMS) Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule (CMS-0057-P) was published December 6, 2022, and was open for comment until March 13, 2023. CMS is currently evaluating the public response for inclusion in a final rule.

This proposed rule emphasizes the need to improve health information exchange to achieve appropriate and necessary access to complete health records for patients, healthcare providers, and payers. This proposed rule also focuses on efforts to improve prior authorization processes through policies and technology, to help ensure that patients remain at the center of their own care.

The rule enhances certain policies from both the CMS Interoperability and Patient Access Final Rule and the December 2020 CMS Interoperability Proposed Rule (withdrawn) and adds several new provisions to increase data sharing and reduce overall payer, healthcare provider, and patient burden through proposed improvements to prior authorization practices.