CMS Prior Authorization Change Summary: Effective January 1, 2026

Date: 12/02/25

On January 1, 2026, the Centers for Medicare & Medicaid Services (CMS) will implement new prior authorization (PA) response time requirements for all providers. NH Healthy Families is opting to implement the PA change before it is required by their MCO Contract with DHHS, and that this does not reflect a statewide (i.e. the other MCOs) change until July 1, 2026.

View the full release here (PDF).