Coverage desk

CMS interoperability

Source-backed reporting and analysis connected to the companies, capabilities, authorities, and operating domains it affects.

July 24, 2026CMS interoperability

CMS-0057-F makes denial reasons operating data

CMS requires impacted payers to provide a specific reason for denied prior-authorization decisions beginning in 2026, while the API provisions add structured status exchange in 2027. The reason must survive the workflow, not appear only in a final notice.

8 minPrimary-source analysis

July 23, 2026CMS interoperability

CMS says prior-auth APIs do not require real-time decisions

CMS's July 20 FAQ says the Prior Authorization API need not produce real-time decisions. Clinical review, reasons, status, and deadline evidence still matter.

8 minPrimary-source analysis