August 12, 2025
Policy Update: Health Data, Technology, and Interoperability: Electronic Prescribing, Real-Time Prescription Benefit and Electronic Prior Authorization (HTI-4) Final Rule, Effective October 1, 2025
On July 31, 2025, the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC) finalized the HTI-4 final rule. The new rule adds several new certification criteria and related standards to the ONC Health IT Certification Program.
Specifically, the rule finalizes the use of certified EHRs to submit prior authorizations, select drugs consistent with a patient’s insurance coverage, and exchange electronic prescription information with pharmacies and insurance plans.
These updates were originally proposed in the HTI-2 NPRM released in August 2024 and were finalized as part of the FY2026 CMS Hospital Inpatient Prospective System (IPPS) final rule (CMS-1833-F). This regulation is effective October 1, 2025.
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