CMS Rule Phases Out Fax Machines; Sets New Standards for Exchange of Clinical Documentation for Health Care Claims

The Centers for Medicare and Medicaid Services (CMS) has released a final rule that will phase out fax machines and paper mailings for health care claims documentation and establish national standards for the electronic exchange of clinical documentation — such as medical records, x-rays and imaging, clinical notes, telemedicine visit documentation and laboratory results. The rule also adopts standards for electronic signatures to ensure secure, authenticated transmission of this information.

“The 1980s called, and they want their fax machines back,” said CMS Administrator Dr. Mehmet Oz in a March 20 press release. “This new rule will modernize American health care 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 standards adopted in the rule apply to Health Insurance Portability and Accountability Act (HIPAA)-covered entities, including health plans, health care clearinghouses, and health care providers that conduct electronic transactions.

The rule is effective on May 26, 2026, and covered entities must comply by May 26, 2028.

CMS estimates the rule will save the health care industry roughly $781 million annually.

Finalization of the rule marks years of work on the issue, dating as far back as 2005. The proposed rule was issued in December 2022 during the Biden Administration. The proposed rule included standards for both health care claims and prior authorization attachments, but the final rule focuses exclusively on health care claims attachments.

Additional Health Care Claims Attachments Final Rule resources, including a fact sheet, FAQ and CMS Town Hall recording, can be found here.