Engagement
Turn CMS interoperability obligations into one sequenced FHIR program with named owners, rather than four API projects competing for the same team.
A CMS interoperability consultant maps the CMS Interoperability and Prior Authorization final rule (CMS-0057-F) to your organization's obligations, then sequences delivery: the operational prior authorization provisions and public reporting that applied from January 1, 2026, and the four API obligations that must be implemented by January 1, 2027. The practical goal is one shared FHIR platform delivered in dependency order with compliance evidence produced as a by-product.
Confirm which provisions and dates apply to your lines of business, then map each obligation to an existing or missing capability.
One FHIR platform serving Patient Access, Provider Access, and Payer-to-Payer exchange, with member attribution, consent, and identity handled once.
Requirement checks, documentation discovery, request submission, and decision return, aligned to the Da Vinci CRD, DTR, and PAS guides and to your existing X12 278 path.
Decision timeframes, specific denial reasons, annual metric reporting, and the data lineage that makes those metrics defensible.
Information on this page is a summary of published CMS material and is not legal or regulatory advice. Confirm obligations and dates for your programs against the rule text and your counsel.
Answers
Direct answers, written to stand on their own.
It requires impacted payers to implement Patient Access prior authorization data, a Provider Access API, a Payer-to-Payer API, and a Prior Authorization API by January 1, 2027, and it imposed operational prior authorization provisions — decision timeframes, specific denial reasons, and annual public metric reporting — from January 1, 2026. Exact applicability varies by payer type.
No. They share member identity, attribution, consent, and FHIR infrastructure. Delivering them as one platform in dependency order reduces rework and gives compliance a single evidence trail.
In governance rather than engineering: unclear applicability, coverage rules that are not authored in a machine-readable and versioned form, and reporting metrics with no owner. Those gaps surface late and are expensive to fix under a deadline.
Schedule a focused conversation to identify your interoperability priorities, risks, dependencies, and most practical next steps.
Whether you are preparing for new CMS requirements, modernizing healthcare integrations, connecting to a QHIN, or building a FHIR-enabled product, BlockInterop can help you define the right path and execute it.
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