Regulatory Updates

CMS Releases Price Transparency Proposed Rule with 60-Day Comment Period. The Centers for Medicare & Medicaid Services (CMS), in partnership with the Department of Labor and the Department of the Treasury, have published a Notice of Proposed Rulemaking (NPRM) updating the 2020 Transparency in Coverage regulations. The proposals aim to improve price transparency by reducing…

WEDI Presents at CMS Listening Session on FHIR Prior Authorization Standard. WEDI presented at a hearing conducted by the Centers for Medicare & Medicaid Services (CMS) National Standards Group on the issue of the use of a FHIR® Standard for conducting prior authorization transactions. WEDI was invited to present along with the Designated Standards Maintenance…

WEDI Submits Comments for OCR’s HIPAA Security Rule Video, Submissions Due Today. WEDI submitted comments on the Department of Health and Human Services’ (HHS) Office for Civil Rights’ (OCR) request for input on topics and questions to be addressed in a video it is producing on requirements for the Health Insurance Portability and Accountability Act…

ASTP/ONC Announces Enforcement Discretion for ONC Health IT Certification Program. The Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC) announced an enforcement discretion notice that applies to the Attestations Condition and Maintenance of Certification requirements and updates related to the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm…

The Centers for Medicare & Medicaid Services (CMS) posted the calendar year 2026 Medicare Physician Fee Schedule (PFS) final rule for public inspection in the Federal Register.  Policy changes to Medicare payments under the PFS, and other Medicare Part B issues become effective on or after January 1, 2026. In addition to payment policies, the…

CMS Provides Overview and Template for CMS-0057-F Health Plan Metrics Reporting. The Centers for Medicare & Medicaid Services (CMS) published the “Prior Authorization Metrics Reporting – Overview & Template” to assist payers impacted by the CMS Interoperability and Prior Authorization (CMS-0057-F) final rule in understanding the metrics reporting requirements. Beginning in 2026, and annually thereafter,…

WEDI Conference on CMS-0057-F Highlights Critical Industry Issues. WEDI held its annual Summer Forum in Chicago on August 5-6 with over 350 attendees participating in the informative event focused on the Centers for Medicare & Medicaid Services (CMS) Advancing Interoperability and Improving Prior Authorization Processes Final Rule (CMS-0057-F). Attendees also had the special opportunity to…

Health Tech Leaders Commit to Innovative Changes Focused on Patients. On July 30, more than 60 major health care and information technology organizations at a White House event pledged to a series of innovative advancements aimed at putting the patient at the center of their care. Early adopters include well-known data networks, health systems and…

OCR Settles HIPAA Ransomware Investigation with New York ASC. The Department of Health and Human Services (HHS) Office of Civil Rights (OCR) announced a settlement with a New York ambulatory surgical center (ASC) for potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Security and Breach Notification Rules. The investigation by OCR followed…

CMS 2026 Medicare PFS Proposed Rule Includes Health IT Provisions. The Calendar Year 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule was released by the Centers for Medicare & Medicaid Services (CMS) and includes numerous proposals for policy, payment, and other requirements, including provisions for health information technology (IT). The Proposed Rule also includes several…