HHS Finalizes HTI-4 Rule: Enhancing Interoperability for E-Prescribing and Prior Authorization
HHS Finalizes HTI-4 Rule: Prior Authorization & E-Prescribing Interoperability HIT
HHS finalized the HTI-4 rule to improve interoperability between prior authorization and e-prescribing.
Summary
The U.S. Department of Health and Human Services (HHS) released the final rule, HTI-4, aiming to improve interoperability for electronic prescribing and real-time prior authorization during patient care. This is expected to ease administrative burdens for providers, patients, and payers.
Key Players
Details
The U.S. Department of Health and Human Services (HHS) has finalized a new rule: the Health Data, Technology, and Interoperability: Electronic Prescribing, Real-Time Prescription Benefit and Electronic Prior Authorization (HTI-4). This rule enables certified Electronic Health Records (EHRs) to submit prior authorizations, select drugs consistent with insurance coverage, and exchange electronic prescription information. Key changes include adopting a new certification criterion for real-time prescription benefit checks, allowing prescribers to access drug cost information at the point of care based on NCPDP standards. Furthermore, standardized electronic prior authorization is supported by new HL7 FHIR criteria, leveraging HL7 Da Vinci Project standards, enabling providers to request coverage info and submit requests directly from certified systems. The baseline standard for electronic prescribing was also updated after five years, making support for electronic prior authorization mandatory. The final rule takes effect on October 1, 2025.
Technology Note
FHIR（Fast Healthcare Interoperability Resources）は医療データ交換の国際標準。このエントリの関連技術: HL7
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