CMS Interoperability and Prior Authorization Rule 2027: Who Pays, Who Falls Behind, and What CFOs Must Do Now
Rachel Barksdale Rachel Barksdale

CMS Interoperability and Prior Authorization Rule 2027: Who Pays, Who Falls Behind, and What CFOs Must Do Now

The clock on CMS's Advancing Interoperability and Improving Prior Authorization Final Rule is no longer theoretical. With a Jan. 1, 2027 deadline for four separate API mandates, a new WEDI survey released at HIMSS26 makes one thing clear: a significant share of payers and providers are not ready, and the financial exposure is growing.

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CMS Medicaid Fraud Crackdown 2026: What Hospital Finance Leaders Must Do Now
Rachel Barksdale Rachel Barksdale

CMS Medicaid Fraud Crackdown 2026: What Hospital Finance Leaders Must Do Now

On February 25, 2026, CMS announced three simultaneous enforcement actions: a $259.5 million Medicaid funding deferral, a nationwide DMEPOS enrollment moratorium, and a request for input on sweeping new fraud detection authority. These followed a year in which CMS suspended $5.7 billion in suspected fraudulent Medicare payments. If your organization operates personal care, HCBS, DMEPOS, or lab service lines, your billing patterns are already visible to the analytics systems behind these actions.

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