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The APIs Are the Easy Part: Maximizing Your ROI While Meeting CMS Interoperability and Prior Authorization Requirements

Sponsored White Paper

This paper covers CMS-0057-F, including information sharing, technical/operational requirements, timelines, and performance improvement opportunities.

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Published on Oct 2, 2024

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Disclaimer

This white paper represents the views of the author, not America鈥檚 Health Insurance Plans (AHIP). The publication, distribution or posting of this white paper by 熊猫视频does not constitute a guaranty of any product or service by AHIP.

Overview

On January 17, 2024, the Center for Medicare and Medicaid Services (CMS) announced the release of a long-expected rule, CMS-0057-F, the CMS Interoperability and Prior Authorization Final Rule (鈥渢he rule鈥�). This rule contains a set of technical and operational mandates intended to support the ongoing move to value-based care and free flow of healthcare information. This document walks through key aspects of CMS-0057-F, including each type of information sharing, associated technical and operational requirements, timelines, and resulting opportunities for performance improvement. We trust it will be a resource shared across your organization to help understand, plan for, and capitalize on this important advancement toward value-based care.