The U.S. Department of Health and Human Services (HHS) has finalized the Health Data, Technology, and Interoperability rule, which will require certified electronic health records (EHR) systems to offer real-time drug cost information and support electronic prior authorization—streamlining clinician workflows, reducing patient surprises and advancing administrative efficiency.

This rule will require certified EHR vendors to embed prior authorization, benefit verification, and e‑prescribing within their EHRs—enabling smoother workflows and eliminating burdensome manual steps like faxing and portal hopping. The updated e-prescribing standards are also intended to improve patient safety by reducing medication errors, providing clearer prescribing directions, and ensuring more accurate dispensing across pharmacies. By integrating prior authorization directly into the prescribing process, physicians will spend less time navigating outdated systems and more time focused on patient care.

Key provisions of the rule include:

• Real-time cost visibility – Physicians and patients will be able to view patient-specific drug pricing and compare alternatives across pharmacies at the point of prescribing.
• Prior authorization – Certified EHR systems must enable physicians to check coverage requirements, compile documentation, and submit and track requests electronically within their existing workflows.
• Interoperability – The rule establishes standardized data flows among EHRs, payors, and pharmacies, replacing inefficient legacy processes.
• Modernized e-prescribing – New prescribing tools will help reduce errors, streamline medication management, and improve coordination between prescribers and pharmacies.

The new rule builds on the 2024 Interoperability and Prior Authorization Final Rule and reflects months of engagement between HHS, CMS, and major health insurers.

The California Medical Association (CMA), American Medical Association and others in organized medicine have made widespread calls over the past decade for meaningful prior authorization reform. AMA has called this final rule a major win for physician practices. “Not to overstate it, but this new policy could contribute to the demise of the fax era in medicine,” said AMA President Bobby Mukkamala, M.D. “By replacing phones, faxes, and portal-hopping with standardized, interoperable EHR connection points, HHS’ new policy turns AMA advocacy into measurable workflow relief and faster decisions.”

CMA will monitor implementation of this new rule and will continue to advocate for policies that reduce administrative burdens, protect physician autonomy and improve patient access to care.