The U.S. Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that would extend prior authorization interoperability requirements to prescription drugs and would explicitly include dental transactions in the updated electronic standards framework.
The rule would require all HIPAA-covered entities -- including dental practices -- to use a common technical standard, known as HL7 FHIR, when submitting prior authorization requests electronically. The goal is to make those requests faster and easier to process across different software systems. The proposed framework builds on the 2024 CMS Interoperability and Prior Authorization Final Rule.
If finalized, the rule could reshape administrative workflows for dental practices by standardizing how prior authorization requests are submitted and processed. CMS is accepting public comments until June 15, 2026.
