Mississippi Medicaid is transforming prior authorization in response to the CMS Interoperability and Prior Authorization Final Rule, replacing slow, manual processes with a more interoperable and consent-driven ecosystem.
This session provides a practical update on the state’s implementation and the steps being taken to support faster beneficiary access to care while reducing administrative burden for providers. The session will explain how FHIR-based Prior Authorization APIs are being deployed alongside Patient Access, Provider Access and Payer-to-Payer APIs. Attendees will see how clinical, claims and eligibility data can be integrated to support compliant prior authorization responses within CMS-mandated timelines, while also advancing broader interoperability goals.
Key themes include state readiness, integration of disparate data sources, intelligent decision support, governance models, technology choices and collaboration across payer and provider stakeholders. The session will also share early lessons, implementation challenges and scalable strategies for meeting 2026 and 2027 compliance deadlines. Attendees will leave with practical guidance for modernizing Medicaid processes, overcoming legacy constraints and turning regulatory requirements into operational and clinical value.
