The Governance Gap: Why Regulatory Risk Has Moved to the Executive Suite

By Elizabeth Geigle, MHA, CPHQ, CHC, Health Insurance Regulatory Specialist 

Healthcare regulation has moved well beyond the compliance function. Today's requirements cut simultaneously across clinical operations, technology, data, contracting, and third-party relationships, demanding decisions that reach the executive suite. As CMS's Interoperability and Prior Authorization Final Rule (CMS-0057-F) and a cluster of state and federal requirements converge on a single January 1, 2027 deadline, health plans, payers, and PBMs face regulatory timelines that arrive faster than any one department can answer alone. The compliance structure may be intact, but the governance around the issue often isn't, and that gap is where regulatory risk now lives.

In this whitepaper, "The Governance Gap: Why Regulatory Risk Has Moved to the Executive Suite", you'll find: 

• The three forces converging at once that have made traditional compliance-only approaches structurally inadequate.

• The single factor that separates organizations that navigate enforcement well from those that don't.

• A four-part governance framework that builds a structured path from near-term readiness to durable executive oversight.

• What true executive readiness looks like for the January 1, 2027 deadline, and what your board needs to see before a regulator asks.

Access the whitepaper by completing the form below.