Regulatory Updates

CMS Prior Authorization of Drugs Proposed Rule Under Review by OMB. The Centers for Medicare & Medicaid Services (CMS) proposed regulation titled “Interoperability Standards and Prior Authorization for Drugs (CMS-0062)” is currently under review by the Office of Management and Budget (OMB). This proposed regulation was included most recently in the Spring 2025 Unified Agenda.…

ASTP Discusses the Era of Patient Engagement. The Assistant Secretary for Technology Policy (ASTP)/Office of the National Coordinator for Health Information Technology (ONC) published a Health IT Buzz post, titled “Digital Dividends Realized: Hospital Patient Engagement Capabilities.” This is the first in a new series in which the agency focuses on patients’ use of electronic…

ASTP Highlights RFI on AI Adoption and Use in Clinical Care. Steve Posnack, Principal Deputy Assistant Secretary for Technology Policy (ASTP), Principal Deputy National Coordinator for Health Information Technology, discusses in the latest Health IT Buzz post the recent request for information (RFI) on the adoption and use of artificial intelligence (AI) in clinical care.…

ASTP/ONC Releases HTI-5 Proposed Rule. The Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC) released the Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) Proposed Rule for a 60-day comment period. The HTI-5 Proposed Rule includes deregulatory actions to update the ONC Health IT Certification…

CMS Releases Price Transparency Proposed Rule with 60-Day Comment Period. The Centers for Medicare & Medicaid Services (CMS), in partnership with the Department of Labor and the Department of the Treasury, have published a Notice of Proposed Rulemaking (NPRM) updating the 2020 Transparency in Coverage regulations. The proposals aim to improve price transparency by reducing…

WEDI Presents at CMS Listening Session on FHIR Prior Authorization Standard. WEDI presented at a hearing conducted by the Centers for Medicare & Medicaid Services (CMS) National Standards Group on the issue of the use of a FHIR® Standard for conducting prior authorization transactions. WEDI was invited to present along with the Designated Standards Maintenance…

WEDI Submits Comments for OCR’s HIPAA Security Rule Video, Submissions Due Today. WEDI submitted comments on the Department of Health and Human Services’ (HHS) Office for Civil Rights’ (OCR) request for input on topics and questions to be addressed in a video it is producing on requirements for the Health Insurance Portability and Accountability Act…

ASTP/ONC Announces Enforcement Discretion for ONC Health IT Certification Program. The Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC) announced an enforcement discretion notice that applies to the Attestations Condition and Maintenance of Certification requirements and updates related to the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm…

The Centers for Medicare & Medicaid Services (CMS) posted the calendar year 2026 Medicare Physician Fee Schedule (PFS) final rule for public inspection in the Federal Register.  Policy changes to Medicare payments under the PFS, and other Medicare Part B issues become effective on or after January 1, 2026. In addition to payment policies, the…

CMS Provides Overview and Template for CMS-0057-F Health Plan Metrics Reporting. The Centers for Medicare & Medicaid Services (CMS) published the “Prior Authorization Metrics Reporting – Overview & Template” to assist payers impacted by the CMS Interoperability and Prior Authorization (CMS-0057-F) final rule in understanding the metrics reporting requirements. Beginning in 2026, and annually thereafter,…