The Department of Health and Human Services (HHS) has announced new prescription drug reforms set to take effect on October 1. These changes stem from the Health Data, Technology, and Interoperability: Electronic Prescribing, Real-Time Prescription Benefit and Electronic Prior Authorization (HTI-4) final rule.
Under this rule, health IT tools certified by the HHS Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology will enable drug prescribers to access real-time drug pricing. This will allow them to compare prices and find lower-cost alternatives covered by a patient's insurance, especially for those under Medicare Part D. Additionally, providers can submit prior authorizations for medical services electronically, which is expected to speed up the process.
The HTI-4 rule was introduced in July as part of the Centers for Medicare & Medicaid Services’ inpatient prospective payment system final rule for fiscal year 2026.
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