Prior Authorization Process Improvements

ForwardHealth is implementing changes to comply with the new CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) by January 1, 2027. This rule is aimed at streamlining prior authorization (PA) processes to improve outcomes for members and increase clarity around the prior authorization process.

This page is specific to PA changes and is not related to the implementation of the Application Programming Interfaces (APIs) that are part of the final rule.

Forms

ForwardHealth will be revising most prior authorization forms for this project. This page will be updated as revisions are published.

ForwardHealth Updates

All ForwardHealth Updates related to this project will be listed here as they are published.

• ForwardHealth Update 2026-09, “Prior Authorization Process Improvements: Revising the Prior Authorization Request Form, Vision Procedure Codes, and Prior Authorization Requirements”
• ForwardHealth Update 2025-38, “Prior Authorization Process Improvements: Removing Spell of Illness and Revising Limits for Therapy Services”
• ForwardHealth Update 2025-35, “Prior Authorization Process Improvements: Overview”

Info Sheets

• Therapies: PT, OT, and SLP Portal PA Request Info Sheet

Provider Resources

• Prior Authorization Process Improvements FAQ
• Portal Account Sign-Up
• Provider Services
• Field Rep Map
• GovD Sign-Up

Video Trainings

All video trainings related to this project will be listed here as they are published.