CMS-0057-F · Interoperability & Prior Authorization Final Rule
The PA landscape
is changing
Starting January 2027, payers must accept electronic prior authorization via FHIR APIs. Here's what it means for your practice — and how TurboPA gets you there.
The shift at a glance
Same request. Two realities.
Follow one prior authorization from order to decision — the way it works today, and the way it works under the new CMS standard.
“Does this need a PA?”
Call the payer. Sit on hold for 20 minutes. Get transferred. Ask if this medication needs prior authorization. Maybe get a clear answer, maybe not. Repeat for the next payer.
Coverage Requirements Discovery
When a provider places the order, the system checks the payer automatically. PA required? Yes or no — with the exact requirements attached — in seconds.
“What documentation do they need?”
Log into the payer portal — if you can remember which one. Download the right form — if it exists. Print the clinical notes. Fill out four pages by hand. Hope you didn't miss a required field.
Documentation Templates & Rules
The payer sends back a structured questionnaire with exactly what they need. The system auto-fills answers from the patient's chart. Staff reviews and confirms.
“Submit and get a decision”
Fax 15 pages of clinical documentation. Call back in two days to confirm receipt. Wait two weeks with zero status updates. Find out when the denial letter arrives — or when the patient calls asking why their procedure was canceled.
Prior Authorization Support
Submit electronically via FHIR API. Tracking ID returned in seconds. The payer must respond within 72 hours for expedited or 7 days for standard requests. Real-time status throughout.
Compliance timeline
January 2026: Payers must meet response time requirements (72 hours expedited, 7 days standard). January 2027: Payers must support FHIR-based electronic PA submission via the Da Vinci PAS API.
Works for every practice
Whether you're a large health system or a two-provider clinic, TurboPA meets you where you are — and gets you ready for where PA is going.
Large health system
Epic, Cerner, MEDITECH
Your EHR vendor will eventually support FHIR PA, but rollout is slow and payer-by-payer. Some payers won't be ready until well after the deadline.
What TurboPA does for you
- Bridge the gap while your EHR builds FHIR PA support
- Handle payers your EHR doesn't connect to yet
- Unified dashboard across all payers, not just FHIR-connected ones
Small & mid-size practice
athenahealth, eClinicalWorks, NextGen
These EHRs may never build full PA automation. Their PA modules are basic form-fillers, not intelligent workflow engines.
What TurboPA does for you
- TurboPA IS your PA system — not an EHR add-on
- Payer intelligence and denial prevention built in
- Works alongside your EHR without replacing it
Independent or paper-based
Small offices, specialty clinics
The new CMS standard requires payers to accept electronic PA, but it doesn't help practices that don't have a system to send it. TurboPA fills that gap.
What TurboPA does for you
- Modern PA workflow without a full EHR investment
- Electronic submission to any payer, from day one
- Track every PA in one place instead of filing cabinets
Get ready for the standard
The deadline is coming whether your practice is ready or not. TurboPA gives you a modern PA workflow today — and a seamless transition to FHIR-based electronic PA when payers go live.