Primary source: ONC, November 12, 2026. Corroboration: Fierce Healthcare, the same day, and Drummond Group, November 11.
On November 12, 2026, ONC and CMS invited payers, providers, hospitals, EHR developers, and intermediaries to test electronic prior authorization together in production-like environments. If your payer’s API is still a promise, the sprint is where you find the break. ONC says the test is voluntary, and that it is not a certification and not a CMS compliance determination.
The date ONC set to express interest. Sprints run 10 to 12 weeks. First-round space is limited. Participation is voluntary. The contact ONC prints is Susan Hull at MITRE, shull@mitre.org.
ONC’s news page is dated November 12, 2026, and marked last updated the same day. The Office of the National Coordinator for Health IT, at HHS, says it announced the events in partnership with CMS. The deck says the testing is ahead of 2027 requirements. The news release does not print a January 1 date and does not name which payers owe an API.
| ONC’s November 12 release says | The release does not say |
|---|---|
| A series of industry testing events in production-like environments, for end-to-end electronic prior authorization. Participants test their own workflows across connected systems and identify gaps before broader implementation. | That anyone is required to attend. Participation is voluntary. |
| Focused sprints of 10 to 12 weeks. ONC, CMS, and the participants test end-to-end workflows in production-like conditions, building on standards development and implementation-guide testing. | The calendar date of the first sprint. |
| Payers, providers, hospitals, EHR developers, intermediaries, and other industry partners. ONC encourages organizations of all sizes, including smaller organizations and those serving rural communities. First-round space is limited. | A roster. No participant is named. |
| Workflows for high-volume and high-priority clinical services, using the HL7 FHIR Da Vinci guides for Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR), and Prior Authorization Support (PAS). Scenarios are coordinated for each event. | Which services. The release says high-volume and high-priority. It does not name a code, a specialty, or a drug. |
| MITRE’s Health Federally Funded Research and Development Center and Drummond Group support recruitment, readiness discussions, participant matching, and testing coordination. Drummond operates FHIRplace, the virtual environment for the test. | That a completed sprint is certification under the ONC Health IT Certification Program, or a determination of compliance with CMS requirements. The release says testing activities are neither. |
| Organizations can express interest by November 20. Additional information: Susan Hull, shull@mitre.org. Findings are meant to identify improvements to standards, educational materials, and implementer guidance. | A change to any compliance date. The release says the work is ahead of 2027 requirements. It does not move a deadline. |
“Federal regulations and industry standards have laid important groundwork for ePA, but our work is not done,” said Tom Keane, M.D., National Coordinator for Health IT. “With our colleagues at CMS, we are bringing partners together to advance the next phase of implementation testing to accelerate ePA progress in the near term.”
Keane’s line is the frame. The groundwork is already written. The unfinished work, in ONC’s telling, is implementation testing with the trading partners who actually exchange the request. “Near term” is his. The release does not define it as a number of days.
| Source | What that source adds |
|---|---|
| Fierce Healthcare, Heather Landi, November 12, 2026, 11:30 a.m. | The lede says the testing is to prepare for federal electronic prior authorization requirements taking effect in 2027. A later paragraph says a federal rule requires some payers to implement an API for electronic prior authorization by January 1. The payers Fierce names are Medicare Advantage, Medicaid managed care, CHIP, and ACA exchange plans. Those two sentences are Fierce’s. They are not in the ONC news release. Fierce also says organizations can sign up by November 20 and that first-round space is limited, which matches ONC’s express-interest line. |
| Drummond Group, November 11, 2026 | Drummond says the initiative is available now and runs through September 2027. That end date is Drummond’s. ONC’s news release does not print it. Drummond says it will support MITRE through FHIRplace and will work with ONC and MITRE to select participants, match them, and coordinate testing. ONC says both organizations support recruitment, readiness, matching, and coordination, and that Drummond operates FHIRplace. Drummond also describes the scope as electronic prior authorization and payer data exchange. The ONC news release is about ePA workflows. |
| Drummond, on its own earlier testing | Drummond says its second and third quarters of 2026 show why the initiative matters. More than 12 member organizations ran 2,653 test executions and uncovered 669 interoperability issues. In the third quarter alone, testing surfaced 311 issues, and 69% have been resolved or remediated. Drummond calls each issue a mismatch that could otherwise appear in a live prior authorization workflow. Those counts are Drummond’s prior testing. They are not results of the sprints ONC announced on November 12. |
“Getting prior authorization data to flow is difficult but necessary to securely advance health data interoperability, and FHIRplace gives payers, providers and intermediaries a shared place to identify issues and prove their systems are interoperable.” — Lisa Palmer, vice president of research, innovation and development at Drummond, in Drummond’s November 11 release. The sentence before it says Drummond is excited to work with MITRE, ONC, and CMS.
ONC says participation is voluntary and that the testing is not certification and not a CMS compliance determination. Fierce’s account of the API date is a description of the existing rule, not a new deadline printed by ONC today. Drummond’s 2,653 executions and 669 issues are earlier Drummond testing, offered as the reason this round matters. They are not a score for a sprint that has not been run. Humata’s WISeR provisional affirmations, the Humana oncology exemption with Evolent and American Oncology Network, and the JAMA letter on WISeR utilization are different programs. Do not file a test registration as a yes.
This is RevCycleAI’s read. The operating gap is between a published implementation guide and a request that leaves your workqueue. CRD, DTR, and PAS are the three guides ONC named. They are the same three guides in the November 3 Humana and athenahealth expansion, which put Humana prior authorization inside athenaOne for more than 180,000 physicians and clinicians. If that path is already live for your Humana book, this initiative is not a second installation of it. It is a matching program for trading partners who still need to watch a request move across connected systems, in a production-like environment, on high-volume services the organizers have not named.
Fierce is the outlet that puts a date on the rule in today’s news cycle. Requirements taking effect in 2027, and an API by January 1 for Medicare Advantage, Medicaid managed care, CHIP, and ACA exchange plans. Read those as Fierce’s sentences. A sprint signup does not, on anything ONC printed today, move that date. A payer can finish a sprint and still owe the API. A provider can skip the sprint and still meet the payer’s portal on January 1. Voluntary means voluntary.
Palmer says FHIRplace is where participants prove their systems are interoperable. ONC says the same activity is not a certification and not a compliance determination. Both sentences can stand. A passed exchange is evidence that two parties moved a prior authorization in a test environment. It is not a CMS letter. Drummond’s useful number is from the testing it already ran: 669 interoperability issues across 2,653 executions in the second and third quarters, and, in the third quarter, 311 issues, of which 69% have been resolved or remediated. That 69% is Drummond’s. This article does not convert the remainder into a failure rate. The point of the figure is that continuous testing found mismatches before they showed up on a live authorization.
The other prior-auth stories from the last two weeks answer different questions. Humata’s November 10 release is about a provisional clinical yes on Oklahoma WISeR, and, the same day, a Humana, Evolent, and American Oncology Network model that drops traditional prior auth for most anticancer drugs at qualifying clinics. The October JAMA letter is about whether targeted Medicare services were used less under WISeR. Today’s item is about whether the electronic request can travel. A connectivity test does not change what Humana waived, and it does not tell you the forgone WISeR service was waste.
September 2027 is how long Drummond says this initiative runs. It is not a statement that Fierce’s January API date slipped. Interest for the first round is November 20, and ONC says space is limited. If your EHR vendor or your intermediary is the party that will sit in the sprint, the question to ask is whether your payers are in the matched set, and whether the scenarios cover the services that actually generate your auth volume. The release says those scenarios will be coordinated. It does not list them.
ONC and CMS opened a voluntary 10- to 12-week electronic prior authorization test on CRD, DTR, and PAS. Express interest by November 20. Fierce says the prior authorization API for Medicare Advantage, Medicaid managed care, CHIP, and ACA exchange plans is still due January 1, with the requirements in 2027. Drummond’s own earlier testing found 669 interoperability issues across 2,653 executions. Passing the new sprint is not a CMS compliance determination.
Put November 20 on the calendar if your payer and your EHR are not already exchanging CRD, DTR, and PAS in production. The test will not gold-card a service, and it will not replace the Humana path inside athenaOne or the Humana oncology exemption. It is a place to see the request fail while there is still a sprint to fix the connection. The rule date, as Fierce states it, does not move because you signed up. Drummond’s September 2027 end date is Drummond’s. The 669 issues are Drummond’s count from the second and third quarters, not this round’s score.
What the test covers, what it cannot certify, and the date that did not move.
Sources: ONC, “ONC and CMS Launch Industry Electronic Prior Authorization Testing Initiative,” November 12, 2026 (page opened; last updated November 12, 2026). The quote from Tom Keane, M.D., is verbatim. The 10- to 12-week sprints, the participant list, CRD, DTR, PAS, the MITRE Health FFRDC and Drummond roles, FHIRplace, the November 20 interest date, Susan Hull at shull@mitre.org, the rural and smaller-organization line, the limited first round, and the sentences that testing is voluntary and is not ONC certification or a CMS compliance determination are the ONC release’s. Fierce Healthcare, Heather Landi, November 12, 2026, 11:30 a.m. (page opened). The 2027 requirements sentence and the January 1 API sentence naming Medicare Advantage, Medicaid managed care, CHIP, and ACA exchange plans are Fierce’s and are not in the ONC news release. Drummond Group, “Drummond Supports MITRE in Advancing Nationwide Payer API Testing,” November 11, 2026 (page opened). September 2027, payer data exchange, more than 12 member organizations, 2,653 test executions, 669 interoperability issues, 311 third-quarter issues, and 69% resolved or remediated are Drummond’s. Lisa Palmer’s quotation is verbatim from that release. The 669 issues are prior Drummond testing, not a result of the November 12 sprints. Linked RevCycleAI articles are earlier events.