This resource is no longer available
The CMS Interoperability and Prior Authorization rule (CMS-0057-F) aims to improve healthcare data exchange and simplify prior authorization. Highlights:
- Patient Access API now includes prior authorization data
- Provider Access API requires payers to share data with in-network providers
- Payer-to-Payer API for data sharing and comprehensive health records
The rule establishes FHIR as essential for healthcare interoperability. Interoperability allows payers to enhance member experiences, foster digital innovation, and enrich data analytics.
Discover how CMS rules offer strategic benefits for payers in the full report.