The Dawn Of The Prior Authorization Transparency Era

What Healthcare Organizations Need to Know

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

On March 31, 2026, the healthcare industry will cross a threshold that fundamentally changes how prior authorization (PA) operates in America. For the first time, Medicare Advantage organizations, Medicaid and CHIP managed care plans, and Qualified Health Plan issuers will be required by the U.S. Centers for Medicare & Medicaid Services (CMS) to publicly post their prior authorization performance metrics. This isn't just another compliance requirement—it's the beginning of a new era of accountability that will reshape competitive dynamics and operational priorities across the healthcare ecosystem.