CMS Issues Drug Interoperability and Prior Authorization Proposed Rule

The Centers for Medicare and Medicaid Services (CMS) released a proposed rule which would build upon the previously finalized Interoperability and Prior Authorization proposed rule by including drugs in the scope of the requirements. Under the proposal, impacted plans must support electronic prior authorization of drugs starting on October 1, 2027. CMS also proposes to update prior authorization metrics for both drugs and non-drug items and services. The proposed rule includes a series of requests for information (RFIs) including those on step therapy and cybersecurity. Comments are due June 15, 2026.