Summary
Improves electronic exchange of health data and streamlines prior authorization by requiring application programming interfaces (e.g., Prior Authorization Support, Patient Access, Payer‑to‑Payer), shorter prior authorization decision timeframes, and new metrics reporting for impacted payers.
Healthcare Implications
Directly affects AI‑assisted prior authorization and care coordination. Payers and providers must integrate Application Programming Interface (API)‑based PA workflows, which enable automation and analytics while preserving transparency, timelines, and patient access.