Cms


Beyond Compliance: Transforming Insights into Impact – The Journey from Analysis to Action

In the first blog of this series, we broached the complexities of the "Assess and Analyze" phase, emphasizing the importance of a thorough understanding of the regulatory...

Beyond Compliance: The Strategic Roadmap – Starting with Assessment and Analysis

The CMS rule on advancing interoperability and improving prior authorization (CMS-0057-F) sets a foundation for future policymaking. As payers embark on this compliance journey,...

CMS Rule Drives New Era of API-Enabled Data Sharing & Prior Authorization Reform

On January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) unveiled a long-awaited final rule aimed at advancing interoperability and enhancing prior authorization...

Recap of the Changes to Medicare Advantage and Medicare Prescription Drug Benefit Proposed Rule

Our December 20 blog shared highlights from the CMS proposed rule for Advancing Interoperability and Improving Prior Authorization Processes, intended to improve patient and...

Providing Perspectives through the Regulatory RFI Process Can Shape the Future of Interoperability

Advancing true healthcare interoperability and data fluidity is dependent upon collaboration, and collaboration requires participation. Recently, the Centers for Medicare and...

Don’t Delay! Prepare for CMS PA & Burden-Reduction Rule Now

The prior authorization process has long been a thorn in the proverbial side of healthcare. Providers, payers, and patients (perhaps most of all) have come to regard this...

Feds Officially Acknowledge Two NCPDP Standards. Part 2. What’s Next

By Pooja Babbrah, Practice Lead, PBM Services and Jocelyn Keegan, Payer/Practice Lead

Feds Officially Acknowledge Two NCPDP Standards. Part 1. Why This is a Big Deal

By Pooja Babbrah, Practice Lead, PBM Services and Jocelyn Keegan, Payer/Practice Lead

What’s Up with the CMS Electronic Prior Authorization Regulation?

By Tony Schueth, MS, Point-of-Care Partners, CEO & Managing Partner