Preparing for 2027 Prior Auth Regulatory Requirements
Prior authorization is one of the biggest sources of administrative burden in healthcare. CMS-0057-F establishes payer API requirements with compliance dates generally beginning January 2027. HTI-4 adds related provider ePA certification criteria.
Medplum supports ePA transactions for payers AND providers and has earned the 2026 FHIRplace Participant emblem from Drummond Group for our engagement in electronic prior authorization (ePA) testing.
Medplum v5 has earned Drummond Validated™ – FHIRplace Silver (CRD) status in both provider and payer roles for Q3 2026. Read the validation announcement for the scope and validation IDs.
FHIRplace is Drummond's multi-party interoperability testing program, where payers, providers, and health IT vendors test real FHIR exchanges against each other rather than against a reference implementation. The Participant emblem recognizes active engagement in FHIRplace testing for 2026. At the time of this announcement, multi-party validation was ongoing.
Why ePA testing matters
Medplum is pursuing certification for all three ONC ePA certification criteria: Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR), and Prior Authorization Support (PAS).
The way to prove these workflows is to test them with real payers and providers. Our electronic prior authorization guide describes how implementation partners can connect to our staging environment and begin CDS Hooks testing with us today.
This work is part of the compliance and revenue cycle themes on our 2026 roadmap. If you are a payer, intermediary, or provider organization preparing for the 2027 API compliance dates, reach out to hello@medplum.com.
The FHIRplace Participant mark is a trademark of Drummond Group, LLC. HL7® and FHIR® are registered trademarks of Health Level Seven International.