The Centers for Medicare & Medicaid Services (CMS) is increasingly promoting and, in some cases, mandating the use of electronic prior authorization (ePA) to improve transparency and efficiency in healthcare transactions. These mandates aim to streamline the prior authorization process and reduce administrative burdens for providers and payers.

The 21st Century Cures Act (2016) promotes interoperability and prohibits information blocking in healthcare, requiring that healthcare providers and systems enable patients to access and exchange their electronic health information securely. This legislation is fostering greater data sharing and patient empowerment in healthcare settings. It also emphasizes the importance of standardized APIs for data exchange to ensure seamless data flow between healthcare providers, patients, and payers, and it enhances patients' access to their health information, promoting greater engagement in their care.

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 includes regulations concerning the privacy, security, and electronic healthcare transactions standards for protecting individuals' medical records and other personal health information. The Department of Health and Human Services (HHS) actively enforces HIPAA regulations to ensure the confidentiality and security of patient data. Recent increased enforcement focuses on breaches and non-compliance related to electronic health records and data sharing practices, resulting in substantial penalties for organizations that fail to protect patient data adequately. Regular audits and investigations are conducted to verify compliance and address potential violations.