ONC’s new Prior Authorization API criteria (g.31–g.33) are essential for developers preparing their products to support CMS reporting beginning in the 2027 performance year. At that point, clinicians, hospitals and CAHs must be able to request a prior authorization electronically via a Prior Authorization API using data from certified electronic health record technology (CEHRT) for at least one medical item or service (excluding drugs) ordered during the CY
2027 performance period.
2027 performance period.
For developers, certification provides several critical advantages:
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Alignment with CMS’s Final Rule: Establish your technology as compliant CEHRT well in advance of the 2027 mandate.
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Support for provider readiness: Give providers confidence that they can meet attestation requirements under MIPS and hospital PI reporting.
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Pilot integration opportunities now: Work with payers already deploying FHIR-based ePA APIs (CRD, DTR, PAS) to reduce implementation risk and gain practical experience ahead of required reporting.
Certification to the Prior Auth API criteria is the technical foundation for providers’ ability to meet CMS requirements. Developers that complete certification now are positioning their technology to remain viable, trusted, and compliant in a market that will require it.
See further details in the CMS Fact Sheet