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,...
HHS Data Strategy: The Vital Role of Consent Management in Bridging Health & Human Services Data
The latest HHS Data Strategy was unveiled back in December, and it's packed with updates that provide valuable insight into their priorities and where they're putting their...
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...
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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