HHS Expands Real-Time Prescription Drug Pricing, Prior Authorization Access

The U.S. Department of Health and Human Services (HHS) has finalized a regulatory reform effective October 1, 2025, aimed at providing patients and providers real-time access to prescription drug price information and streamlining prior authorization processes. This rule mandates certified health IT systems to enable electronic prior authorization submissions, allow providers to view drug prices and insurance coverage details during patient visits, and facilitate electronic exchange of prescription data with pharmacies and insurers. The reform follows a June 2025 roundtable involving HHS Secretary Robert F. Kennedy, Jr., CMS Administrator Dr. Mehmet Oz, and major insurers, who collectively pledged to reduce administrative burdens and enhance transparency for nearly 80% of insured Americans. These changes complement prior CMS initiatives and are expected to improve care decisions, reduce paperwork, and help patients identify the most cost-effective treatments while preventing insurers from blocking physician-approved care. Separately, the Prescription Information Modernization Act of 2025 seeks to replace traditional paper medication inserts with digital formats to improve patient access and comprehension of drug information. Together, these efforts reflect a broader push by the current administration to modernize prescription drug information delivery and affordability.