Today, leaders at the U.S. Department of Health and Human Services (HHS) are celebrating a regulatory breakthrough that will give doctors and their patients unprecedented real-time access to prescription drug information.

The reform will help them identify the most appropriate, cost-effective treatments while preventing health insurers from blocking physician-approved care. Thanks to this rule change taking effect October 1, millions of Americans for the first time will be able to compare drug prices, view out-of-pocket costs, and access prior authorization requirements.

HHS’ final rule ensures that health care providers using certified health IT systems are able to submit prior authorizations electronically, select drugs consistent with a patient’s insurance coverage, and exchange electronic prescription information with pharmacies and insurance plans. It complements important policies advanced by the Centers for Medicare & Medicaid Services (CMS) in recent years and expands interoperability for patients, health care providers, and payers to ease administrative burdens. The rule was finalized through the HHS Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC).

This victory for the American people follows a June 2025 roundtable meeting between Secretary of Health and Human Services Robert F. Kennedy, Jr., CMS Administrator Dr. Mehmet Oz, Director of Medicare Chris Klomp, and major health insurers covering nearly eight in 10 Americans. Health insurers pledged six key reforms to cut red tape, accelerate care decisions, and enhance transparency for patients and providersparticipating in Medicare Advantage, Medicaid Managed Care, Medicare Part D, Health Insurance Marketplace® and commercial plans.

“I commend CMS and ASTP/ONC for moving decisively to overhaul our nation’s broken prior authorization system,” said Secretary Kennedy. “By improving patient outcomes, cutting provider burden, and ensuring full transparency at the point of care, we are delivering on our promise to Make America Healthy Again.”

“This is another step toward delivering on a promise to patients and providers: less red tape, faster answers, and more time focused on care,” said CMS Administrator Dr. Mehmet Oz. “Prior authorization should never stand in the way of timely treatment, and by working with ASTP/ONC and health insurers, CMS is building a system where decisions are transparent, predictable, and centered on patient needs. This is about making care simpler, fairer, and more affordable.”

“Our HTI-4 final rule is a demonstration of ASTP/ONC working collaboratively with our partners at CMS and represents yet another important step in our commitment to ease burdens on providers and speed patients’ access to care,” said Tom Keane, MD, Assistant Secretary for Technology Policy and National Coordinator for Health IT. “ASTP/ONC remains committed to advancing interoperability nationwide and delivering on a vision where data flows seamlessly between providers and payers to lower costs and improve care for all Americans.”

ASTP/ONC, the principal federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information, is working to ensure that providers and payers adopt common, open-industry standards to advance interoperability and industry innovation. Its work serves as a foundation to support CMS payment policies.

The recent, complementary policies from CMS and ASTP/ONC will:

• Accelerate electronic prior authorization through building on CMS requirements for certain payers; health care providers will be able to electronically submit prior authorizations using ASTP/ONC certified health IT, resulting in faster care authorization decisions and more transparency for patients and providers about decisions.
• Improve drug cost transparency because health IT tools certified by ASTP/ONC will enable prescribers to compare drug prices in real time during care encounters and identify lower cost alternatives available under a patient’s insurance coverage, particularly patients covered under Medicare Part D.
• Reduce burden thanks to improvements in workflow automation and more timely, transparent decision-making that have the potential to save millions of hours of clinician time and billions of dollars in labor cost, ensuring clinicians spend more time with patients and less time on paperwork.