CMS Finalizes Rule Modernizing Electronic Health Care Claims Documentation

On March 20, 2026, the Centers for Medicare & Medicaid Services (CMS) finalized the “Administrative Simplification; Adoption of Standards for Health Care Claims Attachments Transactions and Electronic Signatures Final Rule”, establishing the first HIPAA-adopted standards for sending documentation attachments requested by insurers to support health care claims, enabling the secure electronic exchange of supporting clinical documentation such as medical records, X-rays and imaging, clinical notes, telemedicine visit documentation, and laboratory results. The rule aims to create uniform national standards for the electronic exchange of clinical data for health care claims documentation, while attempting to eliminate manual exchange processes, such as fax machines and paper mailings. It also adopts electronic signature standards to ensure exchanges are secure and authenticated. Notably, after significant stakeholder pushback, CMS did not finalize electronic transfer standards for prior authorizations that were included in the proposed 2022 rule. The final rule takes effect May 26, 2026, with payors and providers having until May 2028 to comply with the new standards.