Speakers from the CMS, Office of Burden Reduction and Health Informatics (OBRHI) Health Informatics and Interoperability Group (HIIG) will provide information and insights on the new CMS interoperability mandates and prior authorizations requirements for CMS-regulated payers and health care providers that participate in the CMS Promoting Interoperability program.
On January 17, 2024, CMS released the CMS Interoperability and Prior Authorization final rule (CMS-0057-F). This rule demonstrates CMS’ continued commitment to increasing efficiency by ensuring that health information is readily available by leveraging Health Level 7® (HL7®) Fast Healthcare Interoperability Resources® (FHIR®) standards.
Impacted payers are required to implement certain provisions generally by January 1, 2026. In response to stakeholder comments on the proposed rule, impacted payers have until at least January 1, 2027, to meet the application programming interface (API) development and enhancement requirements in the final rule. The final rule will reduce patient, provider, and payer burden by streamlining prior authorization processes and moving the industry toward electronic prior authorization.
Speakers:
CMS, Office of Burden Reduction and Health Informatics (OBRHI) Health Informatics and Interoperability Group (HIIG)
Lorraine Doo, Senior Policy Advisor
Scott Weinberg, Advisor
David Koppel
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