Impacted payers are required to implement certain provisions by January 1, 2026. However, in response to stakeholder comments on the proposed rule, impacted payers have until primarily …
With the stakes considerably higher in this second round of CMS interoperability, payers have a chance to achieve a value trifecta: Compliance with CMS-0057-F, use case extensibility, and …
The CMS Interoperability and Prior Authorization Final Rule supports our efforts to simplify how healthcare information and prior authorization data are shared across a member’s healthcare …
CMS has finalized new electronic prior authorization measures for 2027 in which providers will report on their use of the prior authorization API. Payers will build one side of the API while …
CMS-0057-F provides healthcare organizations an opportunity, and requirement, to improve the patient experience and dramatically reduce administrative burden related to prior authorization.
In the dynamic healthcare sector, seamless and effective communication between payers and providers is vital. The newly introduced CMS Interoperability and Prior Authorization Final Rule …
CMS will work with state Medicaid and CHIP FFS programs that may be unable to meet the new prior authorization decision timeframes compliance date in 2026.
Rule (CMS-0057-F) on January 17, 2024. This final rule emphasizes the need to improve health information exchange to achieve appropriate and necessary access to health records for …
Yes, for the Patient Access API, to the extent Payers maintain data that is now included in the classes in Version 3 of the United States Core Data for Interoperability (USCDI), those data …
What Are the Key Takeaways from the Final Rule? The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) is a significant step toward improving how healthcare …