Monday August 4, 2025

Welcome to Chicago, whether in person or virtually! Day 1 of WEDI’s annual Summer Forum starts tomorrow and the speakers, sponsors, and staff are still working fast and furiously to deliver the latest information to you. There has been no summer vacation for the CMS Promoting Interoperability and Prior Authorization (CMS-0057-F) regulation and its implementation.

The WEDI Education Leadership Team closed their meeting on Tuesday July 29 by saying everything was set with the Summer Forum content. And with that, the policymakers in D.C. said, “not so fast, my friend.” The next day was the White House health technology event where more than 60 major health care and information technology organizations pledged to voluntarily implement the CMS Interoperability Framework (“Framework”). While much of the criteria within the Framework appear to not relate specifically to CMS-0057-F, the Framework is facilitating a technology ecosystem that will allow faster and more secure data sharing through data exchange standards and connectivity, digital identity tools, and patient-facing apps. This ecosystem is part of the larger goal of CMS-0057-F, which is to get the right data to the right place more efficiently to improve patient access to care and decrease burden on the industry as a whole.

And not be overlooked, ASTP/ONC announced on Thursday the publication of the “Health Data, Technology, and Interoperability: Electronic Prescribing, Real-Time Prescription Benefit and Electronic Prior Authorization” (HTI–4) final rule in the Hospital Inpatient Prospective Payment system final rule. What is HTI-4, you ask? You don’t remember this proposed rule, you say. Me either. But this final rule is well timed as it sets to raise the floor and bring more standardization and functionality to prior authorization. It is finalizing some items that were proposed in the “Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability” (HTI-2) proposed rule. Specifically, there are new certification criteria and related standards for the ONC Health IT Certification Program for electronic prescribing, real-time prescription benefit checks, and electronic prior authorization.

With the commitments, calls to action, and energy from last week, we will jump head first into the deep end with our first day and a fantastic line-up of speakers and content, all made possible by our sponsors.

The morning starts with honoring our former CEO, Charles Stellar, who has taken time away from his busy retirement schedule to join us in Chicago. Next, InterSystems (platinum sponsor!) will guide us in a group activity of identifying the key elements needed for the CMS-0057-F transformation to happen. Make sure the coffee is flowing, and our brains are firing on all cylinders!

Our first panel with Vaishali Dubey (Florida Blue), Danielle Lloyd (AHIP), Kendra Obrist (Point-of-Care Partners), Andrea Preisler (American Hospital Association), and Ron Wampler (Aetna, a CVS Health Company) will talk about how their organizations are using the implementation of CMS-0057-F to shape the future of burden reduction and data exchange for prior authorization. Following a networking break and a chance to catch our breath, Jason Van Der Jagt from Edifecs, a Cotiviti Business, (platinum sponsor!) will present on how health plans can use FHIR in the delivery of care and identify patient needs sooner. Our next panel sponsored by Itiliti Health (platinum sponsor!) includes Jim Adamson (Point-of-Care Partners), Michael Lunzer (Itiliti Health), Heather McComas (American Medical Association), Cara Wahmann (HCSC), and Ron Wampler will be discussing business challenges and the critical components that can interfere when automating workflows.

After lunch, Itiliti Health will demo a platform solution that will take the complexity out of your current hectic, and often unruly, prior auth processes. The panel that follows will focus on the importance and challenges of the Document Templates and Rules API with Terry Cunningham (American Hospital Association), Celine Lefebvre (American Medical Association), Greg LeGrow (athenahealth), Stephan Rubin (Optum), and Julie Smith (InterSystems).

Another networking break and time to stretch our legs is followed by a session sponsored by Drummond Group (a gold sponsor). Panelists Timothy Bennett (Drummond Group), Denny Brennan (MDHC), Michael Marchant (Sutter Health), Mark Scrimshire (Onyx Health, gold sponsor!), and Ron Wampler will share up-to-the-minute testing experiences and lessons learned. Then, Keith Brick from Itiliti Health and Mark Scrimshire from Onyx Health team up to demo a CMS-0057-F-compliant prior authorization solution.

To end the day, CMS is holding a listening session for open discussion and questions from the attendees. Participating for CMS will be David Koppel from the Office of Burden Reduction and Health Informatics and Katie Brooks, Nora Simmons, and Emanuelle Vasilak from the Office of Healthcare Experience & Interoperability. Don’t miss this opportunity to ask your questions directly to CMS staff and hear their answers. Get more from them in person than what you can read in the fact sheets, FAQs, and guidance published by CMS.

After a full day of education, everyone will need some sustenance, and there is nothing better in Chicago than Chicago-style pizza. A networking reception at Pizano’s is the perfect way to refuel for Day 2. Attendees will want to be well refreshed for the second day with more speakers, including 1upHealth (gold sponsor!), Tennr (silver sponsor!), and Itiliti Health.

Oh, yes, and if there are any more major government announcements or regulations, we will bring them to you on Day 2!