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...
Washington State Takes a Leap to Require FHIR APIs and Reshape Prior Authorization
Washington State has taken a pioneering leap in reshaping the landscape of prior authorization, racing ahead of federal guidelines by mandating the use of FHIR (Fast Healthcare...
Decoding Medicare's Proposed Rule: Insights for Health IT Stakeholders
Yearly adjustments in healthcare policies are the norm, with some years marking more notable changes. Among these, the Centers for Medicare & Medicaid Services (CMS) consistently...
Navigating Regulatory Compliance and Innovation in Payer Technology
Healthcare technology policy, especially rules impacting payers, are coming at us at a fast and furious pace coupled with new enforcement teeth. Executives and leaders in payer...
Could Gold-Carding be a Transformative Factor for Prior Authorization?
The concept of "Gold-carding” is an emerging policy trend that has the potential to significantly transform prior authorization (and claims) procedures. As an evolving concept, it...
Pharmacy Interoperability: A Review of POCP's Response to ONC's Proposed Rule on Health Data, Tech, & Interoperability
Point-of-Care Partners (POCP) recently responded to the Office of the National Coordinator for Health Information Technology (ONC) proposed rule on "Health Data, Technology, and...
HHS Proposed Rule to Standardize Attachments: A Step Back from Automation
On December 21, 2022, the Department of Health and Human Services (HHS) issued a proposed rule that would regulate standards for health care attachment transactions. These include...
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