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Federal requirements for electronic prior authorization will take effect on January 1, 2027, requiring Medicare Advantage and other plans to support standardized electronic prior authorization. To help hospitals and health systems prepare, join the AHA, CMS, and Epic for a discussion of both the policy intent behind the requirements and the operational realities of implementation.

CMS will provide an overview of the electronic prior authorization requirements and key implementation considerations, followed by insights from Epic on how these workflows are expected to function within provider systems. Participants will gain practical perspectives on challenges organizations may encounter and steps they can take now to prepare for implementation.

Why You Should Attend:

This webinar explores how hospital and health system leaders can prepare for Medicare Advantage’s new electronic prior authorization mandate, which goes into effect Jan. 1, 2027. Experts from the AHA, the Centers for Medicare & Medicaid Services and Epic will discuss workflow integration, implementation challenges and practical readiness strategies.

Learning Objectives:

  • Identifying whether prior authorization is required
  • Reviewing coverage and documentation requirements
  • Sending patient and clinical information
  • Submitting the authorization request
  • Receiving payer responses
  • Checking authorization status
  • Receiving approval, denial, or requests for more information

Information covered in the presentation:

  • How Does Electronic Prior Authorization Work?
  • What Are the CMS Prior Authorization Decision Timeframes?
  • What Information Must Be Included With a Denial?
  • What Is the CMS Prior Authorization API?
  • What Is FHIR and Why Does It Matter?
  • Does Electronic Prior Authorization Mean Fax and Portals Will Disappear?
  • Electronic Prior Authorization and MIPS
  • Electronic Prior Authorization for Hospitals and CAHs
  • What Should Medical Practices Do Before 2027?

Who Will Benefit:

  • Hospital and Health System Leadership (CEOs, CMOs, CIOs)
  • Clinicians and Ordering Providers (Physicians, Nurse Practitioners, Physician Assistants)
  • EHR and IT Infrastructure Teams
  • Revenue Cycle and Prior Authorization Specialists
  • Payer Relations and Compliance Officers
  • Health system executives, clinical care teams, IT/EHR leadership, and revenue cycle staff

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