CMS targets prior auth delays with 72-hour drug approvals
Supply Chain Pulse — 2026-04-11
CMS is proposing to slash prior authorization response times for drugs from weeks to 72 hours for standard requests and 24 hours for urgent cases—a seismic shift that could reshape pharmacy operations across every health system. The sweeping reforms, part of a broader push to digitize healthcare workflows, arrive as providers grapple with massive market consolidation that's reducing competition in nearly half of metro hospital markets. It's time to start planning how your teams will handle faster drug approvals while navigating an increasingly concentrated—and demanding—healthcare landscape.
Quick Hits
- Elevance Health reshuffles Carelon leadership ahead of May executive departure (Modern Healthcare)
- EverSea Medicines acquiring Hasten Biopharmaceuticals for $250M (Pharmaceutical Business Review)
- Mississippi hospital cutting 86 jobs in latest healthcare layoffs (Modern Healthcare)
- Epic, Oracle Health, Meditech now control 90% of EHR market (Modern Healthcare)
- HHS pilots mobile clinics for rural oncology, wound care access (Modern Healthcare)
CMS proposes 72-hour drug prior authorization mandate
The agency wants to require insurers to respond to prior authorization requests within 72 hours for standard drug requests and 24 hours for urgent cases, down from current timelines that can stretch weeks. For supply chain teams managing pharmacy operations, this could mean dramatic workflow changes and the need for new systems to handle faster turnaround times. The rule also mandates electronic prior authorization by 2027, potentially eliminating fax-based processes that still plague many health systems.
Health system consolidation reaches tipping point in metro markets
One or two health systems now control hospital markets in 47% of metropolitan areas, up from previous years, according to new KFF data. This concentration gives dominant players significant leverage with suppliers and could reshape procurement strategies, potentially leading to more standardized product selections but also reduced negotiating power for smaller systems. Supply chain professionals should expect continued pressure to demonstrate value as health systems seek economies of scale.
Function Health buys Getlabs in at-home lab testing consolidation
The acquisition expands Function Health's direct-to-consumer lab capabilities, reflecting growing demand for home-based diagnostic services that bypass traditional hospital lab networks. For health system lab managers, this trend represents both competitive pressure and potential partnership opportunities as patients increasingly expect convenient, at-home testing options. The move signals continued investment in decentralized diagnostic services that could reshape traditional lab supply chains.
CMS launches digital health ecosystem tools
The agency rolled out its first wave of interoperability tools designed to create a "fully digital, patient-centered health system," including new standards for electronic data exchange. Supply chain teams should prepare for increased pressure to integrate with digital workflows and ensure their procurement systems can interface with these new federal standards. This represents the foundation for CMS's broader push away from fax-based communications toward real-time electronic processes.
Wellstar CEO plans aggressive expansion amid rising demand
The Georgia-based nonprofit is building new hospitals and expanding ambulatory care hubs to meet growing patient demand, signaling confidence in inpatient growth despite industry predictions of continued outpatient migration. Supply chain teams supporting expansion should expect increased capital equipment purchases and the need to establish vendor relationships for new facilities. The move contrasts with other systems that are consolidating rather than expanding their physical footprint.
Boehringer invests $50M in Click's digital schizophrenia therapy
The pharma giant secured market rights for CT-155, a regulatory-approved digital therapeutic, as the digital health market shows strong growth. For supply chain professionals, this signals the need to develop procurement frameworks for software-based therapeutics that don't follow traditional medical device or pharmaceutical supply chains. Digital therapeutics represent a growing category that requires new vendor management and compliance processes.
Source: Medical Device Network
Providers expand mental health services as access crisis deepens
Health systems are rapidly scaling behavioral health programs, but executives worry they can't move fast enough to address deteriorating access to mental healthcare. Supply chain teams should prepare for increased demand for specialized equipment, telehealth technologies, and facility modifications to support expanded mental health services. The expansion represents both a supply chain opportunity and a challenge to source specialized behavioral health products quickly.
CMS asks hospitals to limit ultra-processed foods on patient menus
Following RFK Jr.'s eat-real-food campaign, CMS sent hospitals a memo requesting limits on ultra-processed food options for patients. Food service supply chains may need to source more fresh, whole food ingredients and adjust vendor relationships with processed food suppliers. While not mandatory, the guidance could influence hospital food procurement strategies and require new sourcing approaches for healthier menu options.
You're receiving this because you subscribed to Supply Chain Pulse, a daily brief for healthcare supply chain professionals. Unsubscribe