Standardized electronic prior authorizations

Standardized electronic prior authorizations. (1) By January 1, 2025, all health insurance issuer or designee utilization review organization shall make available a standardized electronic prior authorization request transaction process using an internet webpage, internet webpage portal, or similar electronic, internet, and web-based system. (2) Not later than January 1, 2027, all health care professionals and health care providers shall be required to use the standardized electronic prior authorization request transaction process made available as required by subsection (1) of Rule 19.20. (3) Not later than January 1, 2027, all health insurance issuers or designee utilization review organization shall comply with the Centers for Medicare & Medicaid Services, CMS-0057-F, Prior Authorization and Interoperability Final Rule (2024), regarding automation of prior authorization application programming interfaces.