Blue Shield of California continues to demonstrate its leadership in transforming health care by becoming one of the first health plans to commit to the Electronic Prior Authorization (ePA) Pledge with the Centers for Medicare & Medicaid Services. This pledge is part of the agency’s broader Health Tech Ecosystem initiative.
Today, the Electronic Prior Authorization pledge brings together payers, providers, electronic health record vendors, and digital health developers around a shared goal: make prior authorization seamless, in real-time, and fully interoperable for every patient. By signing on, Blue Shield is committing to go beyond the minimum Centers for Medicare & Medicaid Services requirements, and to help build prior authorization workflows that function across the healthcare system — not just within Blue Shield, or within individual organizations and health plans.
For members and providers, this work is a step forward in addressing prior authorization as one of the biggest pain points in health care.
This commitment builds on Blue Shield’s broader Prior Authorization Reimagined initiative, launched in October 2024. The Centers for Medicare & Medicaid Services pledge also closely aligns with Blue Shield’s prior authorization commitments made in June 2025 through AHIP (formerly America’s Health Insurance Plans) and the Blue Cross Blue Shield Association, including the goal of delivering real-time responses for 80% of prior authorizations by 2027.
Importantly, the new Health Tech Ecosystem reflects growing collaboration across the healthcare industry, bringing providers and electronic health record vendors directly into the process, acknowledging that change can’t happen with payer action alone. Stellarus, part of the Ascendiun family of companies, develops healthcare technology solutions and will act as Blue Shield of California's preferred technology partner. Ascendiun is the parent company for both Blue Shield of California and Stellarus.
As part of the pledge, Blue Shield will support:
- Building standardized FHIR (Fast Healthcare Interoperability Resources) digital platforms so different health systems can automatically share prior authorization information with each other in real time
- Using the same simple, consistent steps for prior authorization no matter who’s involved
- Providing real-time status updates and clear decision outcomes, including standardized denial reasons
- Making the entire process visible and trackable from start to finish
The Electronic Prior Authorization commitment marks Blue Shield’s second major pledge this year with the Centers for Medicare & Medicaid Services and the Center for Medicare and Medicaid Innovation to improve member care and experience. Earlier this year, Blue Shield was among the first to commit to advancing outcomes-based payment models to assist with chronic care.