Inside CMS' new interoperability rule — What it means for health plans

The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) represents a significant compliance lift. However, payers have the opportunity to leverage the rule as a means to accelerate broader transformation.

From streamlining prior authorizations to integrating clinical, claims and SDOH data, the rule’s FHIR®-based API requirements can do more than meet federal deadlines — they can improve HEDIS, reduce provider abrasion and support better member experiences.

This in-depth whitepaper breaks down what CMS-0057-F means and how health plans can leverage it to turn mandatory implementation into meaningful return.

Inside you’ll find:

  • A clear breakdown of what’s required and what’s not
  • Real-world strategies for API deployment, data integration and workflow design
  • How compliant infrastructure can support value-based care alignment, STAR performance and care collaboration

Please fill out the form to download the whitepaper.

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