ONC and CMS Seek Participants for Prior Authorization Testing Sprints

The Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) are recruiting payers, providers, electronic health record (EHR) developers, and intermediaries for voluntary testing sprints focused on electronic prior authorization. The planned sprints will run for 10–12 weeks and test workflows based on Fast Healthcare Interoperability Resources (FHIR). Expressions of interest are due November 20, 2026. The initiative is intended to bring organizations involved in healthcare transactions together to examine how the workflows perform across systems and identify interoperability issues.

The timing makes the effort relevant to organizations preparing for the January 1, 2027, API implementation deadline applicable to certain CMS-regulated health plans. Testing ahead of that date may help participants identify technical and operational friction points before implementation requirements take effect. Findings may also inform future standards updates and guidance, although the source does not specify what changes may result or guarantee that sprint findings will be adopted.

For government contractors and healthcare technology companies, the key distinction is that this is a voluntary testing opportunity, not a solicitation, contract award, or formal compliance determination. Participation may provide practical insight into FHIR-based prior authorization workflows and interoperability challenges, but the announcement does not describe paid work, funding, or a procurement vehicle. Business development teams should therefore treat the sprints as an engagement and market-awareness signal rather than a near-term revenue opportunity, while contractors supporting health plans or providers can assess whether clients may benefit from participation.

The invitation spans multiple stakeholder types—payers, providers, EHR developers, and intermediaries—reflecting that electronic prior authorization depends on coordination across organizations and technology platforms. The provided source identifies Drummond Group and MITRE among vendors associated with the signal, but does not specify their roles in operating or participating in the sprints. The cited source also contains an unrelated headline about Army contract-writing system users; that item does not establish a connection to this healthcare initiative and is not treated here as part of the sprint announcement.

• ONC and CMS are seeking expressions of interest from payers, providers, EHR developers, and intermediaries.
• The planned testing sprints are voluntary and expected to last 10–12 weeks.
• The workflows under test use FHIR for electronic prior authorization.
• Expressions of interest are due November 20, 2026; interested organizations should verify participation details through the agencies’ announcement.
• The effort is not a contract solicitation, paid procurement, or formal compliance determination.
• Sprint findings may inform standards updates and agency guidance, but no specific changes or outcomes are guaranteed.
• The work is relevant to preparations for the January 1, 2027, API implementation deadline for certain CMS-regulated health plans.
• Contractors can use the announcement to identify client readiness and interoperability support needs, while avoiding characterization of participation as a funded opportunity.
• Drummond Group and MITRE are named in the supplied vendor data; their specific roles are not stated in the source content.