Posts by lcanaley

WEDI to Participate in CMS Listening Session on Prior Authorization Standard, Holding MPA TODAY-November 17. WEDI has been invited to participate in a listening session on prior authorization being held by the Centers for Medicare & Medicaid Services’ (CMS) National Standards Group on December 10, 2025. The listening session will focus on benefits and challenges…

WEDI Holds MPA on Prior Authorization Standard. WEDI held a Member Position Advisory (MPA) facilitated discussion to review questions from the Centers for Medicare & Medicaid Services (CMS) for its December 10 listening session on evaluating the Fast Health Interoperability Resources (FHIR®) prior authorization standard. WEDI, along with the six Designated Standards Maintenance Organizations, was…

Senators Request Information from CMS on Medicare Advantage Provider Directory Issues. Senators Jeff Merkley (D-OR), Ranking Member of the Senate Budget Committee, and Ron Wyden (D-OR), Ranking Member of the Senate Finance Committee, sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, MD, requesting responses to potential issues with the…

QHIN Technical Framework V2.1 Posted for Review, Responses Due November 7. The Qualified Health Information Network® (QHIN™) Technical Framework (QTF) v2.1 is available for review on the TEFCA Topics in Change Management webpage. Comments on the draft QTF are being accepted until November 7. The Trusted Exchange Framework and Common Agreement™ (TEFCA™) Topics in Change…

CMS Issues Update on Holding of Claims for Affected Services. The Centers for Medicare & Medicaid Services (CMS) provided an update on the processing of claims and payments for services affected by the expired Medicare legislative provisions as of October 1. CMS has instructed Medicare Administrative Contractors to hold these claims but will continue to…