Good News for a Friday Afternoon!!!!!

December 05, 2025

The “Interoperability and Prior Authorization Final Rule” Implementation Memo has posted – read it carefully:

• It primarily shortens standard service authorization requests from 14 to 7 calendar days
• The rules apply to Managed Care and Medicaid (and CHIP) FFS including DBHDS for DD Waiver, Modivcare, Dentaquest and Acentra Health for FFS requests, but the application to DD Waiver Service Authorization will not occur until 1 July, 2026.
• The timeline for readiness for all other covered services is January 1, 2026.

Read the description of Standard and Expedited Requests carefully and note the reporting requirements.