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House passes bill to install electronic prior authorization in Medicare Advantage plans

A Key FHIR Bill Passed in the House: The Improving Seniors’ Timely Access to Care Act just passed by the House establishes an electronic prior authorization process to streamline approval of requests and create a process for “real-time decisions” for services that are routinely approved.

Fortunately, the HL7 Da Vinci FHIR Accelerator project has been working on FHIR-based standards for the prior authorization process that meet these requirements since 2018. Implementations of these standards are now being tested in FHIR Connectathons and real-world pilot projects. This is just one example of how a modern healthcare standard like FHIR can enable not just the exchange of healthcare data but the modernization of healthcare processes.

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