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CMS to phase out fax machines and snail mail, saving over $780M annually

The Centers for Medicare & Medicaid Services on Friday announced plans to eliminate the use of faxes and snail mail, a move that would save taxpayers a projected $781 million. 

CMS said it will soon seek to streamline healthcare payments by focusing instead on electronic transactions. While fax machines have largely disappeared from everyday life, many hospitals and radiology groups rely on the outdated technology to send clinical documentation supporting payment claims.

Under the final rule, CMS would establish national standards for the electronic exchange of such documentation. The agency said it plans to adopt new standards for e-signatures, aiming to ensure “secure, authenticated transmission of this information.” 

“The 1980s called, and they want their fax machines back,” CMS Administrator and former TV personality Mehmet Oz, MD, MBA, said in a statement March 20. “The futuristic medical breakthroughs we’ve achieved, like augmented reality glasses that give surgeons X-ray vision, shouldn’t have to coexist with administrative systems that often lag decades behind. This new rule will modernize American healthcare by standardizing electronic claims attachments and enabling secure electronic signatures.”

CMS said the rule will officially take effect in 60 days, with covered entities having until May 2028, to comply. The agency contends its rule will establish a “consistent, easy to use” electronic framework for transmitting clinical documents to support claims. These often can include X-rays, clinical notes, telemedicine visit documentation and lab results. Despite the widespread availability of digital tools, radiology groups are often forced to use faxes due to reliability issues and Health Insurance Portability and Accountability Act compliance requirements, vendors note.

The new standards apply to all HIPAA-covered entities including health plans, healthcare clearinghouses and physicians. CMS touted other potential benefits that will include time savings, faster care delivery and enhanced security. The agency’s fact sheet offers further details on the X12 and Health Level 7 standards it will use beginning in two years. 

An original proposed rule issued in 2022 included standards for both healthcare claims and prior authorization attachments. However, this final rule focuses solely on claims. Health and Human Services said it will continue to evaluate alternative standards for prior auth attachments, which are currently being tested by the industry.

 
 

Industry responses 

The American College of Radiology said Monday it does not anticipate the change having a huge impact on the specialty. However, ACR said it will keep a close eye on the rollout for any potential implementation issues. 

Meanwhile, the Radiology Business Management Association said Monday it appreciates any efforts to modernize administrative processes and “reduce reliance on outdated manual methods such as faxing and mailing.” The trade group also supports industry efforts to transition toward fully electronic communication for claims submission, records review requests and other documentation. 

“Radiology groups nationwide already rely heavily on electronic transmission for filing claims and conducting routine interactions with Medicare,” Linda Wilgus, MBA, RBMA’s co-executive director, told Radiology Business March 23. “However, many practices have continued using manual processes when submitting supporting documentation and attachments because of limitations in current Medicare Administrative Contractor systems. For this reason, RBMA believes it is essential to better understand how CMS plans to implement this new policy and what technical standards will be used.”

The association urged CMS to clarify three aspects of rule implementation, which it believes are still unclear: 

  1. MAC Readiness and Infrastructure: “Will all Medicare Contractors across the country have the necessary technology and secure systems in place to accept electronic attachments consistently and reliably? Past experience has shown considerable variation among contractors, and RBMA is concerned that uneven implementation could disrupt workflows and burden practices.”
  2. Impact on Claims Processing Timelines: “While the intent is to streamline processes, there is uncertainty regarding whether the transition will actually reduce administrative delays or potentially create new bottlenecks during the early stages of implementation. RBMA seeks assurance that the new approach will not slow down claims adjudication or medical review activities.
  3. Updated Requirements for Signatures: “Many MAC policies still require ‘wet’ signatures for certain forms or attestations. RBMA requests clarification on whether CMS will update these requirements to align with a fully electronic submission model, which would be essential for consistency and true administrative simplification.

“RBMA supports CMS’ goal of eliminating unnecessary manual processes and improving efficiency across the Medicare program,” Wilgus added. “We will continue monitoring implementation and compliance across all MAC jurisdictions, gather feedback from our members, and share any challenges or needed refinements with CMS.”

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Google rolls out 2 new open access AI models aimed at medical imaging

Google this week unveiled two of its latest artificial intelligence-enabled models, both of which could be impactful in the medical imaging industry. 

MedGemma 1.5, Google’s latest vision-language model, and MedASR, the company’s new automated speech recognition model, were both designed and trained specifically for healthcare. Google is making each model available publicly so researchers and developers can have access to the new technology. 

The updated version of the tech giant’s vision-language model can analyze medical images and written text. It has been revised to include enhanced multimodal reasoning and also includes improved options for fine-tuning in accordance with specialized datasets. MedGemma 1.5’s is intended for answering image-based medical questions, drafting radiology reports and extracting pertinent clinical data. The MedGemma applications deployed on Google Cloud also include full DICOM support. 

Google indicates the updated vision-language model’s accuracy in classifying disease-related findings has improved since the rollout of its predecessor, MedGemma 1. The company believes the model will be helpful for many research-related tasks. It has signaled that the response to the first MedGemma model “has been incredible.” 

 
 

“The adoption of artificial intelligence in healthcare is accelerating dramatically, with the healthcare industry adopting AI at twice the rate of the broader economy,” a news release from Google notes. “In support of this transformation, last year Google published the MedGemma collection of open medical generative AI models through our Health AI Developer Foundations (HAI-DEF) program. HAI-DEF models like MedGemma are intended as starting points for developers to evaluate and adapt to their medical use cases, and they can be easily scaled on Google Cloud through Vertex AI.” 

MedASR is a speech to text model designed for medical settings. It was trained on healthcare-specific language and has been fine-tuned to improve medical dictation accuracy. Google says that compared to other generalist ASR models, MedASR records 58% fewer errors for general imaging dictations and up to 82% fewer errors related to rare diseases and diverse speakers. It can be adapted to different medical specialties and varying workflows as needed. 

Both models are available now. Learn more here.

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CMS Releases Final Rule Implementing HIPAA Standards for Health Care Claims Attachments

The U.S. Department of Health and Human Services (HHS) Centers for Medicare and Medicaid Services (CMS) released a final rule on Friday establishing new standards for the electronic transfer of claims documentation, including a new standard for electronic signatures to ensure that claims attachment transactions are secure, authenticated, and compliant with federal regulations.

While electronic health records have been widely adopted by healthcare providers, the healthcare industry is still reliant on outdated methods for transferring attachments to support electronic health care claims. The exchange of health care claims remains a manual process, with the necessary documentation transferred by fax or physical mail. These outdated methods of data transfer result in delays to patient care, increased health care costs, and place a considerable administrative burden on clinicians. The final rule modernizes health care administration, resulting in cost savings, time savings, enhanced security, improved efficiency, and faster care delivery.

“The 1980s called, and they want their fax machines back,” CMS Administrator Dr. Mehmet Oz said. “The futuristic medical breakthroughs we’ve achieved, like augmented reality glasses that give surgeons X-ray vision, shouldn’t have to coexist with administrative systems that often lag decades behind. This new rule will modernize American healthcare by standardizing electronic claims attachments and enabling secure electronic signatures. Because every minute providers save on paperwork is another minute they can spend caring for patients.”

The CMS collaborated with industry stakeholders when developing its proposed rule and received considerable feedback from health plans, healthcare providers, healthcare clearinghouses, technology vendors, patients, and consumers, which shaped the final rule. The final rule was published in the Federal Register on March 24, 2026, and takes effect on May 26, 2026. The new standards apply to all HIPAA-covered entities – health plans, healthcare providers, and healthcare clearinghouses – and compliance with the new standards is required by May 26, 2028. While HIPAA-covered entities have two years to ensure compliance, they are encouraged to read and review the final rule and start implementing the new standards promptly.

The final rule – Administrative Simplification; Adoption of Standards for Health Care Claims Attachments Transactions and Electronic Signatures Final Rule – implements the requirements of the administrative simplification subtitle of HIPAA and the Patient Protection and Affordable Care Act, and establishes the first-ever standards for healthcare claims attachments under HIPAA. The final rule will enable the secure electronic exchange of healthcare claims-related supporting documentation, including medical records, medical images, clinical notes, telemedicine visit documentation, and laboratory results. The new standards are anticipated to save the healthcare sector up to $782 million each year, according to the CMS, and will allow clinicians to spend more time providing care for patients.

The final rule adopts definitions of “attachment information,” “electronic signature,” and “health care claims attachments transaction,” and adopts standards for health care claims transactions and digital signatures used in conjunction with health care claims attachments transactions.  The final rule also adopts X12N standards for data exchange and Health Level 7 (HL7) standards for sharing clinical data.

While the proposed rule included electronic transfer standards for prior authorizations, after considering the comments received, the CMS omitted the proposed electronic transfer standards for prior authorizations from the final rule due to conflicts with currently mandated standards for prior authorization. The CMS will continue evaluating other standards for prior authorizations.