CMS Advancing Interoperability and Improving Prior Authorization Processes proposed rule.

CMS Interoperability and Prior Authorization Proposed Rule announced
CMS Advancing Interoperability and Prior Authorization Proposed Rule

403 Pages of Transformative Regulation dropped yesterday, December 7, 2022. (

The Proposed rule will be officially published on the Federal Register on 12/13/2022. it covers:

A. Patient Access API

B. Provider Access API (Bulk FHIR)

C. Payer to Payer Data Exchange on FHIR

D. Improving Prior Authorization Processes

E. Electronic Prior Authorization for the Merit-based Incentive Payment System (MIPS)

The deadline would be Jan 1, 2026 but, if you read more closely Payers will need to implement some parts of the regulation by Jan 1, 2025 in order to be able to produce metrics.

This is extensive regulation that Payers need to start preparing for now!

There will be plenty more to come as we digest this information. At Onyx we are ready to help payers meet these new requirements. Let’s talk!

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