CMS-0057 Readiness: Challenges We’re Seeing and How Health Plans Can Move Forward
By Mark Scrimshire, Chief Interoperability & Security Officer, Onyx Health; Co-Chair, HL7 Financial Management Work Group; active contributor to WEDI The reality today By January 1, 2027, health plans are expected to have APIs live across Patient Access, Provider Access, Payer-to-Payer, and electronic Prior Authorization (ePA). Earlier this year, WEDI’s baseline survey found that 43 […]
A Day in the Life of CMS-0057: What It Means for Members, Providers, and Health Plans
CMS-0057, the Interoperability and Prior Authorization Final Rule, introduces four APIs that will shape how health data moves across the ecosystem: Payer-to-Payer Data Exchange – At the member’s request, securely transfer up to 5 years of their data when they switch plans. Provider Access – Give in-network providers access to a member’s data. Patient Access […]