The American Medical Association (AMA) is urging the U.S. Centers for Medicaid and Medicaid Services (CMS) to uphold its Jan. 1, 2027 deadline for electronic prior authorizations under its Interoperability and Prior Authorization final rule.
In a Sept. 18 letter (PDF) to CMS Administrator Mehmet Oz, M.D., AMA President John Whyte, M.D., wrote the agency should maintain its deadline and “reject broad enforcement discretion during 2027.”
“CMS should stay the course and remain steadfast in its commitment to ‘axe the fax’ and make [electronic prior authorization (ePA)] a reality for physicians and patients,” Whyte wrote.
Through the rule, payers are required to implement an application programming interface (API) to support a better, more efficient electronic automation process. Insurers are also expected to have a prior authorization API, expand on patient access API and implement a provider access API.
The agency expects the changes will result in approximately $15 billion in savings over 10 years, Fierce Healthcare previously reported.
Whyte wrote insurers are “citing limited physician engagement” with ePA to “justify a delay” while simultaneously “mischaracterizing that limited engagement as a lack of physician interest.”
“This is a catch-22: physicians are portrayed as unwilling to use ePA, yet physicians are not receiving needed education and support from health plan and EHR developer partners, which perpetuates physician ‘unwillingness,’ and so on,” Whyte wrote. “This is a manufactured problem created to justify a delay.”
The organization urged CMS to call on EHR developers to give implementation timelines, testing opportunities and more. Additionally, AMA offered to help the agency in providing physicians with “clear questions for EHR developers and health plans.
“Staying steadfast will protect patients, prepare physicians, and secure the Administration’s legacy of making ePA work in practice, not merely on paper,” Whyte wrote.
In May, CMS announced 29 healthcare organizations—including UnitedHealthcare, Cigna and Aetna—signed onto a pledge for the electronic prior authorizations as “early adopters.”
Despite payers’ pledges to streamline the process, a December 2025 AMA survey found physicians are skeptical. Only a third (33%) of the 1,000 physicians surveyed said they believe that the payers’ pledge last summer would lead to significant change.