WEDI Captures Provider and EHR Perspectives on CMS 0057-F
The third session of the WEDI Spotlight Series: CMS 0057 Implementation Update discussed how health care providers and EHR vendors are implementing this complex set of new requirements. With previous sessions covering Access APIs (Payer to Payer, Provider Access & Patient Access) and Payers & Prior Authorization, this discussion focused in on the impact that this new era of application programming interface (API) standards could have on providers and how their EHR partner will support them in this implementation journey. WEDI Board Chair-Elect Denny Brennan from the Massachusetts Health Data Consortium served as moderator for the event.
The Spotlight first offered a technical walkthrough of the rule by nationally recognized API expert Mark Scrimshire, from Onyx Health. Mark outlined the rule’s requirements, timelines and potential impact for streamlining and accelerating patient care authorization decisions. Health care technology vendors next took the stage and weighed in on how EHR vendors are incorporating APIs into provider workflows. Ryan Bohochik (Epic), Hans Buitendijk (Oracle), representing the HIMSS Health Record Association, and Gregory LeGrow (athenahealth) discussed the API tools currently in development with expected releases in early to mid 2026.
Preeminent physician informaticist Steven E. Waldren, MD, MS, from the American Academy of Family Physicians, presented insights from the Health Level 7’s Da Vinci Project Clinical Advisory Council. Dr. Waldren discussed implementation barriers and outlined effective provider API adoption strategies. He emphasized that APIs represent a unique opportunity for physicians to automate many of the current prior authorization processes, allowing them focus more on clinical work.
Denny next led a panel discussion featuring Michael Marchant (Sutter Health), Heather McComas (American Medical Association), Arna Meyer (Albion Dental Technology), Andrea Preisler (American Hospital Association), Semira Singh (Providence), and Anna Taylor (MultiCare Connected Care). Panelists referenced recent survey results from the American Medical Association that highlighted the burden associated with current prior authorization processes and the potential impact on patient care. Anna highlighted their early collaboration with Regence, their local health plan. Well in advance of the national mandate, these two partners have successfully deployed APIs for prior authorization since 2022, paving the way for other providers and payers. The panelists all concurred that automating the prior authorization process is widely welcomed on the provider side, with expectations of increased productivity, improved patient care, and better communication between payers and providers.
Implementing scalable workflows and standard-based solutions for prior authorization continue to present significant challenges for providers. To prepare for this technology transformation, it is critical that providers receive education on these new prior authorization processes. In addition to educating providers on this landmark federal regulation, WEDI will highlight in an upcoming Spotlight emerging innovation in the prior authorization space, including the use of AI to facilitate more efficient automation of tasks. Go to WEDI.org “Events” for a list of all upcoming programs.
Access the full recording of this insightful provider/EHR program HERE and go HERE to access the first two 0057-F Spotlights