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Prior Authorization in 2026: What CMS-0057-F Changed, and What It Didn’t

CMS-0057-F went into effect on January 1, 2026, requiring faster prior authorization decisions, specific denial reasons, and the first public reporting of payer approval and denial rates. But the rule left submission methods, clinical criteria, and drug prior authorizations untouched. Here is what actually changed, what stayed the same, and where your RCM team should be focusing right now.