Delaware is going first. The work can be shared.
Delaware is bringing public leadership, health plans, providers, DHIN and technology partners together around electronic prior authorization. The goal is not simply to replace paper with APIs. It is to remove repeated work and make the process clearer for people and care teams.
From announcement to implementation
The initiative was announced in July 2026, followed by the July 13 launch event and synthetic-data Connectathon, where 14 organizations connected to the shared test environment.
July 20 — Insurance Commissioner Navarro convened the state’s payers. July 30 — Surgeon General Hockstein presented the model to 40 state Medicaid directors. August 7 — The model was presented to the CEOs of 45 state hospital associations. August 14 — The Delaware Healthcare Association brought the major health systems and Epic together.
On August 31, the first market-readiness session brought together 53 participants. Teams worked through testing capacity, provider reach, EHR and workflow gaps, and repeated counterparty test plans.
The question was practical: which work can be shared, and what still needs to happen for a provider and plan to use the connection together?
September 3 — Commissioner Navarro and SHN presented the model to the 12-state Northeast Zone insurance commissioners. September 9 — The first Cut Paperwork, Not Care | State Leaders Roundtable brought together participants from 11 states, from New Hampshire to Hawaii. The Roundtable now meets monthly so states can share methods, compare progress and support one another’s implementation.
The road to January
The planned schedule combines regular working sessions with hands-on testing and preparation for live use.
| When | Shared work |
|---|---|
| August 31 | First market-readiness session, held with 53 participants. |
| September 28 | Action Forum · Progress to January: test results, updates and blockers; Rhyme and Microsoft present. |
| October 14 | Virtual Prior Authorization Connectathon: synthetic end-to-end testing. |
| October 26 | Action Forum: defects, remediation and reusable patterns. |
| November 30 | Action Forum: production readiness and contingencies. |
| December 1 | Limited production begins for accepted medical prior-authorization workflows. |
| January 1, 2027 | Production milestone: activate additional pathways as ready. |
Contact the team for participation details and schedule updates. Synthetic testing is open between sessions.
What the work should deliver
A provider can submit a request. A plan can ask for more information or return a decision. The relevant users can see the latest update and know who needs to act. The teams know how to resolve a failure and who supplies support.
The implementation should also make later connections easier. Record the work reused and the effort that remains, rather than count an announcement or registration as a completed result.
A starting point for other markets
Other states and organizations can join the shared learning without building a parallel program. Bring the systems and partners you already have and identify what Delaware’s work can help you reuse.
Participation remains voluntary. The state retains its own program authority, and each organization retains its decisions and responsibilities.
Join the next step
Name an implementation lead. Bring a workflow or an obstacle. Start a synthetic test or join the next Action Forum.
Announcements and coverage
Read the original state announcement, July event recap and related coverage for the history of the initiative.
Historical sources: Original state announcement → · July event recap → · Axios coverage →
Last updated: September 2026