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CMS Finalizes its Proposal to Advance Interoperability and Improve Prior Authorization Processes | Sheppard Mullin Richter & Hampton LLP

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes. ....

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Centers for Medicare and Medicaid Services Interoperability Propo

Centers for Medicare and Medicaid Services Interoperability Propo
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CMS Issues A New

On December 6, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a Proposed Rule that would (i) further enhance health data exchange by establishing data exchange standard. ....

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How health plans can mitigate the bumps along the road to implementing CMS' interoperability rules

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Back in 2019, the Proposed Interoperability rules were released from ONC and CMS, and the […]
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Back in 2019, the Proposed Interoperability rules were released from ONC and CMS, and the final version of these rules were published in March 2020. While there were some changes implemented based on comments received, largely the new rules kept a lot of the original requirements along with the timelines for implementation. Some of those timelines have been pushed out due to the coronavirus pandemic, but the first payer deadline will be upon the industry before we know it.
Payers have their work cut out for them, although many have hired consultants and partnered with vendors to help implement the first phase of the rule: Patient Access Application Programming Interface (APIs) and Provider Directory. With a relatively short implementation window of January 2021 (with a 6-month grace period on enforcement), that’s not a lot of time to get ready fo ....

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