Issued2025-08-04

HTI-4 Final Rule – Electronic Prescribing, Real-Time Prescription Benefit, and Electronic Prior Authorization

Final RuleSector

Summary

Finalizes new and updated ONC Health IT Certification Program criteria and standards for electronic prescribing, real-time prescription benefit information, electronic prior authorization, and related API functionality as part of the FY 2026 IPPS final rule.

Healthcare Implications

Standardizes health IT capabilities that support electronic prior authorization and point-of-care prescription benefit checks, requiring developers and healthcare organizations to update certified modules and workflows. The rule supports automated administrative and decision-support processes but does not itself establish general AI safety or model-governance requirements.

Impact Level

Medium

Keywords

Transparency & Governance; Clinical Quality & Efficacy

Stakeholders

Providers & Health Systems; Patients & Public; Payers & Purchasers; Developers & Vendors; Regulators & Government