Primary source: Inovalon, November 11, 2026, Bowie, Md. and Arlington, Va. The same release is posted on DrFirst.
On November 11, 2026, Inovalon and DrFirst said they have signed a definitive agreement for Inovalon to acquire DrFirst. If you run prior authorization or pharmacy benefit work, the asset is the screen where the prescription is written. The price was not disclosed, and the deal has not closed.
Definitive agreement, datelined Bowie, Md. and Arlington, Va. Subject to regulatory approvals and customary closing conditions. Together, the companies say they will serve over 2,000 hospitals and 240,000 prescribing providers writing 241 million or more prescriptions a year across 270 or more EHR integrations. Those figures are the release’s. No price is estimated.
| Element | November 11 release |
|---|---|
| What was signed | A definitive agreement for Inovalon to acquire DrFirst. Not described as closed. |
| What the combination adds | Real-time prescription drug and prior authorization capabilities, inside clinical workflows. DrFirst offerings named: prescribing, prior authorization, benefit determination, and patient communications. |
| Combined scale, as the release states it | Over 2,000 hospitals and 240,000 prescribing providers writing 241 million+ prescriptions a year across 270+ EHR integrations. |
| Inovalon, company-reported | Over 50,000 active, licensed customers. Primary-source data of more than 99 billion medical, pharmacy, and lab events across 1.1 million clinicians, 736,000 clinical settings, and 461 million unique lives. Bowie, Md. |
| DrFirst, company-reported | More than 670,000 providers, 71,000 pharmacies, 270 EHRs, and over 2,000 hospitals. Solutions help over 100 million patients a year. Arlington, Va. Founded over 25 years ago. James F. Chen is named in the Inovalon CEO’s quote as the founder. |
| People named | Adam Kansler, CEO of Inovalon. Laizer Kornwasser, CEO of DrFirst. |
| Investor and advisors | Nordic Capital is named as Inovalon’s lead investor. Citigroup is exclusive financial advisor to DrFirst. Skadden is DrFirst’s legal advisor. Goldman Sachs is financial advisor to Nordic Capital and Inovalon. Kirkland & Ellis is legal advisor to Inovalon and Nordic Capital. McDermott Will & Schulte is regulatory, privacy, and healthcare counsel to Inovalon. |
| Conditions | Required regulatory approvals and other customary closing conditions. |
| Price | Not disclosed. |
The 240,000 figure and the 670,000 figure are not the same sentence. The combined line counts prescribing providers. DrFirst’s About counts providers. The release also uses “over 2,000 hospitals” in the combined sentence and “over 2,000 hospitals” in the DrFirst About, and it uses “270+ EHR integrations” next to “270 EHRs.” Those are the companies’ measures, printed as printed. This article does not add them, subtract them, or turn them into one census.
“DrFirst brings customer-focused solutions that help doctors and other providers improve medication access and adherence for their patients. As we continue to invest in innovation, DrFirst’s clinical-grade AI will further extend our reach to the point of care, helping inform the clinical decisions that shape each patient’s treatment. Together, we will have the opportunity to make a meaningful difference in outcomes across healthcare,” said Adam Kansler, CEO of Inovalon. “Founded over 25 years ago by technology visionary James F. Chen, DrFirst has repeatedly demonstrated its commitment to improving healthcare and outcomes for patients. We have deep respect for what the DrFirst team has built, and we intend to invest in the business, keep customers at the center of all we do, and create new opportunities for our teams as both companies enter their next phase of growth.”
“Joining Inovalon is a natural next step for DrFirst. For over 25 years, we’ve worked inside clinical workflows to simplify medication management for providers and patients. Inovalon’s complementary workflows, data and analytics let us drive closer coordination with everyone involved in a prescription. That gives patients the best opportunity to get the medications they need faster and stay on the therapies that keep them healthy,” said Laizer Kornwasser, CEO of DrFirst.
Kansler’s operating line is the point of care: DrFirst’s clinical-grade AI, in his words, extends Inovalon to the decision that shapes treatment. The second half of the quote is a keep-and-invest sentence. He says Inovalon intends to invest in the business. Kornwasser’s line puts Inovalon’s workflows, data, and analytics next to the clinical workflow DrFirst already sits in, so a patient can get the medication faster and stay on it.
The November 11 release says definitive agreement. It says the transaction is subject to required regulatory approvals and other customary closing conditions. It does not state a price, a close date, or a revenue figure, and none is estimated here. HCI Innovation Group’s November 11 account reports the same agreement and says financial terms were not disclosed. A HIT Consultant item the same day retells the signing and adds workflow detail the company release does not print, including formulary alternatives, out-of-pocket estimates, pharmacy coupons, and a payer rules engine. Those lines are not facts in this article.
This is RevCycleAI’s read. A pharmacy can stop a script for a missing prior authorization, a formulary miss, or a benefit the prescriber never saw. That rejection does not have to land in the claim-denial queue your billing office works. The medical claim and the prescription are different queues. The release says the combination adds real-time prescription drug and prior authorization capabilities, and it names the four DrFirst offerings: prescribing, prior authorization, benefit determination, and patient communications. Payer-scale data on one side. The prescribing screen on the other.
What you can take to a staff meeting is the location of the check, not a savings rate. If benefit determination and drug prior authorization run while the prescriber is still in the session, the avoidable reject is the one that never becomes a pharmacy callback, an abandoned fill, or a medical-necessity fight after the patient has left. The release does not say whose benefit file will be on that screen, whose prior-authorization rules, or whether the pharmacy reject will show up in a health system’s denial workqueue. It does not print a rejection rate, an abandonment rate, or a dollar of drug revenue recovered.
Inovalon’s own survey of RCM leaders, which we wrote up in August, said 93% of organizations still handle prior authorization by phone, fax, or portal. That survey is not this acquisition. It was not a count of drug authorizations, and the acquisition release does not cite it. A separate November story, Humana and athenahealth, is the medical prior-authorization path inside an EHR. This agreement is the prescribing path. The survey, the Humana connection, and this signing stay three separate workflows.
CMS-0057-F, the 2024 interoperability and prior authorization final rule, leaves drugs out. The rule says the policies for prior authorization APIs and processes do not apply to drugs of any type. The decision deadlines in that rule, expedited requests within 72 hours and standard requests within seven calendar days, generally begin January 1, 2026, and the Prior Authorization API begins January 1, 2027. CMS says the exact compliance dates vary by payer type. Those clocks are for medical items and services.
Drug prior authorization already has other clocks, and the final rule says so in the section explaining the exclusion. Medicare Advantage must respond to an expedited Part B drug request within 24 hours and to a non-expedited request no later than 72 hours, with similar timelines for Part D. When a state requires prior authorization for a covered outpatient drug, Medicaid’s response is 24 hours. The gap the rule itself names is the drug that is not a covered outpatient drug and is not sitting on those Part B or Part D clocks.
On April 10, 2026, CMS released a proposed rule, CMS-0062-P, that would extend electronic prior authorization and decision notice to drugs. It is a proposal. The fact sheet sets compliance dates beginning October 1, 2027, and the clocks are not one number. State Medicaid fee-for-service, Medicaid managed care, and CHIP managed care would decide drug requests on a timeframe that lines up with the existing covered-outpatient-drug clock, no later than 24 hours, or with the items-and-services clocks, seven days standard and 72 hours expedited. State CHIP fee-for-service would have 24 hours for prescription drugs for which federal financial participation is available. Qualified health plan issuers on the federally facilitated exchanges would notify the requesting provider no later than 72 hours on a standard drug request and no later than 24 hours on an expedited one. The same fact sheet proposes that specified payers support the NCPDP SCRIPT, Formulary & Benefit, and Real-Time Prescription Benefit standards for pharmacy-benefit drugs beginning October 1, 2027, and that Medicaid, CHIP, and those exchange issuers give a specific reason when they deny a drug prior authorization.
Read that against the asset Inovalon just signed to buy. Real-time prescription benefit and drug prior authorization, inside the prescribing workflow, are what a payer would need if those proposed standards and clocks become final. The release does not say this acquisition is how any payer will comply, and the proposal is not a final rule. Medicare Advantage drug clocks that already exist are not this proposal.
Inovalon just signed to put its data next to the prescribing screen, where a benefit check or a drug prior authorization can stop a prescription before a medical claim exists. The price is blank. The close is not done. CMS-0062-P would pull more drug decisions onto shorter clocks beginning October 1, 2027, and it is still a proposal.
Read the workflow, not the hospital count. Ask which benefit file and which prior-authorization rules will be in the e-prescribing session, and whether a pharmacy reject is visible to the team that works your denial queue. The release names prescribing, prior authorization, benefit determination, and patient communications. It names Citigroup and Skadden for DrFirst, and Goldman Sachs, Kirkland & Ellis, and McDermott Will & Schulte for Inovalon and for Nordic Capital, the lead investor. It does not name a price. Until a closing document does, this is a signed agreement to move the benefit check to the prescription.
What was signed, which prior-auth clock is still a proposal, and the number the release actually printed.
Sources: Inovalon, “Inovalon To Acquire Intelligent Medication Management Company DrFirst,” November 11, 2026, Bowie, Md. and Arlington, Va. (page opened); the same release on DrFirst (page opened); HCI Innovation Group, November 11, 2026 (page opened; reports the agreement and that financial terms were not disclosed); HIT Consultant, November 11, 2026 (page opened; additional workflow claims in that item are not in the company release and are not used as facts); CMS fact sheet, CMS-0057-F; CMS-0057-F final rule (drug exclusion and the existing Part B, Part D, and Medicaid covered-outpatient-drug timelines described in that rule); CMS fact sheet, CMS-0062-P, April 10, 2026 (proposal; compliance dates beginning October 1, 2027). Quotes from Adam Kansler and Laizer Kornwasser are verbatim from the company release. The 2,000 hospitals, 240,000 prescribing providers, 241 million+ prescriptions, 270+ EHR integrations, and both companies’ About figures are company-reported. The 240,000 and 670,000 counts are left as separate measures. No price was disclosed, and none is estimated. The August Inovalon prior-authorization survey is a different RevCycleAI article and is not a result of this agreement.