Programmable Medical Necessity & the Pricing Computation Layer: How Prior Auth API Infrastructure, Claims-Derived Transparency Data, and ERISA Fiduciary Litigation Are Rewiring Commercial Healthcare

The prior authorization API stack — CRD, DTR, PAS, and the Da Vinci implementation guides — is turning utilization management from a labor-arbitrage cost center into a programmable transaction layer. At the same time, ERISA fiduciary litigation is rewriting what employers owe their employees in terms of price transparency and benefit design. This episod…