Posts by lcanaley

CMS Posts Materials from Listening Session on Advancing Adoption of X12 Version 008060. The Centers for Medicare & Medicaid Services (CMS) posted materials from the agency’s July 1 Listening Session on advancing the adoption of X12’s Version 008060 administrative transactions. WEDI and the six Designated Standards Maintenance Organizations (Dental Content Committee, Health Level 7, National…

OMB Reviewing Final Rules for HTI-5 and Transparency in Coverage. The Office of Management and Budget (OMB) is reviewing two final rules. The first regulation is the Office of the National Coordinator for Health Information Technology’s (ONC’s) “Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity” final rule, known as “HTI-5.” The proposed…

Key Prior Authorization Policies Finalized in FY2027 CMS IPPS Final Rule. The Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) partnered to finalize key Fast Healthcare Interoperability Resources (FHIR®) electronic prior authorization policies impacting the 2024 CMS Promoting Interoperability and Advancing Prior Authorization Final Rule…

CMS Posts New FAQs on CMS-0057-F, Includes Metric Reporting Template. The Centers for Medicare & Medicaid Services (CMS) posted new Frequently Asked Questions (FAQs) on the Prior Authorization application programming interface requirements in the CMS Interoperability and Prior Authorization (CMS-0057-F) final rule. Included in the FAQs is information on the public reporting by impacted payers…

CMS Releases CY2027 Medicare PFS Proposed Rule. The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2027 Medicare Physician Fee Schedule (PFS) proposed rule. In addition to the physician payment proposals, other proposals address value-based care programs and Medicare accountable care organizations (ACOs). Proposed improvements to the Medicare Shared Savings Program…