Shipping PA features means scraping payer sites or hiring a rules team — neither scales. Connect your UM platform, EHR, or PA automation stack to Auth57's verified rule data via REST. JSON in under 200ms, scoped to the states you subscribe to, verified against CMS-0057-F and CMS-0062-P.
GET /v1/pa-lookup?state=CA&drug=enbrel
A single GET returns the PA verdict, PA type, clinical criteria, submission target, turnaround times, confidence score, and a source URL. No paginated rule trees to walk. No webhook plumbing.
Base URL: api.auth57.io
Auth: x-api-key header
curl https://api.auth57.io/v1/pa-lookup \ -H "x-api-key: your_key" \ -G \ -d "state=TX" \ -d "program=medicaid_mco" \ -d "drug=glp1_weight_loss"
{
"state": "TX",
"program": "medicaid_mco",
"query": { "drug_class": "glp1_weight_loss" },
"result": {
"pa_required": true,
"pa_type": "full",
"confidence": "high",
"federal_override": false,
"last_verified": "2026-04-01",
"source_url": "https://...",
"next_steps": [
{ "step": 1, "title": "Gather clinical documentation" },
{ "step": 2, "title": "Submit PA request" }
]
},
"served_from": "blob",
"timestamp": "2026-04-06T10:30:00Z"
}Every Medicaid, Medicare Advantage, CHIP, and federal-exchange QHP plan needs FHIR-based PA APIs by Jan 1, 2027. Auth57 is the verified rule layer underneath those APIs — and the same data feed for anyone building PA features outside the payer.
Standard PA decisions in 7 days, expedited in 72 hours. Structured denial reasons retrievable by API. Annual metric reporting. Auth57 gives you the verified rule data your FHIR endpoint has to return.
Extends electronic PA to 20 drug classes under the medical benefit — immunomodulators, oncology injectables, biosimilars, GLP-1s. The API already covers these classes; the regulatory deadline catches up next.
Same dataset, four very different surfaces. Pick the one that fits your product — the API doesn't care.
Render the verdict, PA type, and submission target on the order screen. Stop sending clinicians to a payer portal mid-encounter.
See request shape →Swap the rules team and the brittle scrapers for a verified data feed. One vendor for all 51 states, every program, with a citation trail.
Endpoints →Use Auth57 as the verified rule layer behind your FHIR PA APIs. Beats hiring a 12-person PA-data team to be ready for Jan 1, 2027.
Mandate brief →Give your agent a deterministic source for PA verdicts. Same dataset our MCP server exposes — addressable as REST when MCP isn't on the menu.
Developer guide →npm install @auth57labs/sdkTyped client for Node, Deno, Bun, Cloudflare Workers, Vercel Edge, and every modern browser. Zero runtime dependencies. Optional Lit-based <auth57-pa-lookup> Web Component for embedding the verdict UI directly on customer sites.
import { Auth57Client } from '@auth57labs/sdk';
const client = new Auth57Client({
apiKey: process.env.AUTH57_API_KEY!,
});
const verdict = await client.paLookup({
state: 'CA',
program: 'medicaid_ffs',
service: 'advanced_imaging',
});
console.log(verdict.result.pa_required);
console.log(verdict.result.source_url);Plain GET requests over HTTPS, JSON in, JSON out. The full spec lives at /api-reference — Swagger UI, downloadable OpenAPI 3.1 doc, generated client examples.
Runs on Vercel Edge — globally distributed, sub-200ms response times from anywhere in the US.
Single-state PA lookup and multi-state divergence comparison are both included. No tier-locking the second endpoint.
Every PA-required result includes clinical criteria, submission target, and turnaround times — ready to render in your UI.
Query by drug class code or service category. Drug coverage spans 20 drug classes across all 51 states.
Your API key is automatically scoped to your subscribed states. Out-of-scope requests return a clean 403 — no surprise overage charges.
Every response carries source_url and last_verified. Your audit team gets a citation trail, not a guess.
Every rule is monitored, verified, and updated by our team before it reaches you. We read the sources — CMS bulletins, state Medicaid agency notices, payer policy updates — so your team never has to call to confirm.
Step therapy requirement updated. Prior treatment failure documentation now required. Effective April 1, 2026.
Reviewed by Auth57 team · Source: HHSC Medicaid bulletin
Proposed exemption for FDA-approved biosimilars under review. Not yet in effect — team monitoring.
Auth57 team review in progress · Source: DHCS bulletin draft
Quarterly verification complete. No changes to PA requirements for oral oncology agents.
Verified April 2026 · Source: NJDOH policy manual
Annual billing locks in the lower rate. Switch to monthly any time.
Or $299/mo billed monthly · cancel anytime
Enterprise plans available — book a call
Integrate in an afternoon. Scale from there. The OpenAPI spec, sample requests, and a live curl on the reference page are enough to wire a working PA lookup before your standup ends.