Must read CMS HHS

CMS Finalizes Interoperability & Prior Authorization Rule (CMS-0057-F), Effective April 2024

A sweeping 231-page final rule mandates FHIR-based APIs for patient access, provider access, and payer-to-payer data exchange — and sets hard new timelines for electronic prior authorization across Medicare Advantage, Medicaid, CHIP, and FFE health plans. Published February 8, 2024 and effective...

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federalregister.gov · Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Advancing Interoperability and Improving Prior Authorization Processes (CMS-0057-F) · Feb 8