Achieve and Maintain Compliance with CMS Interoperability Mandates While Realizing ROI Value from Interoperable Usable Data for Healthcare
The most recent CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) is a mandate with significant regulatory compliance requirements. Building from the foundation of CMS-9115-F, CMS-0057-F accelerates the shift to broader adoption of FHIR APIs to enable seamless access and exchange of interoperable healthcare data.
Navigating the complexities of CMS-0057-F requirements to meet the rapidly approaching CMS deadlines requires payers to prioritize readiness planning without delay.
CMS-0057-F Implementation by the Numbers
50+ New Requirements
30-Month Implementation Timeline (CMS Estimate)
Turnkey CMS Interoperability Compliance Modules Support All Mandated FHIR APIs for CMS-9115-F and CMS-0057-F and Reporting Metrics for CMS-0057-F
Patient Access API
Provider Access API
Payer-to-Payer API
Electronic Prior Authorization (ePA) Support
Modular, Scalable Design for Impacted Payers of All Sizes, At All Levels of Readiness
We meet you wherever you are on your CMS Interop compliance journey.
Existing contract with CMS9115 vendor – Abacus can implement the CMS0057 APIs and Metrics and drive efficiencies between the two solutions
Not yet live with CMS-9115-F or switching vendors – Accelerated migration/implementation of a patient access solution to meet CMS January 1, 2026 reporting requirements and reduce the burden of rework required to make available additional patient data and information as required under CMS-0057-F
Have your own plan to meet requirements for electronic prior auth (ePA) – We can provide only the ePA metrics and/or routing capabilities while deploying the CMS-0057-F modules for patient access, provider access, and payer-to-payer interoperability
Flexible Cloud-Based Architecture, Deployable in Any Environment
We deploy on AWS and Azure, in our cloud or yours, providing flexibility and greater control over your CMS interoperability integration plan and scheduleD
Usable Data Assets Empower an Interoperability Strategy That Unlocks ROI Value
Transparent, governed, normalized and standardized claims and clinical data models provide the foundation for an enterprise ecosystem of data assets that can be transformed and enriched to support business use beyond compliance, including in key areas such as quality, value-based care, risk adjustment, and building a longitudinal member record.
Industry-Leading Data Security and Privacy for Peace of Mind
HITRUST r2-certifed and SOC 2-certified with compliance and data security built into every layer of the Abacus platform, designed to protect your members’ data, keep you compliant, and provide peace of mind.
Choose Abacus because our CMS Interoperability Data Solution delivers much more than regulatory compliance: It’s a strategic investment in your interoperability data strategy as the foundation for driving improved experience, outcomes, and performance across the healthcare ecosystem.
Contact us today to start working on your CMS interoperability compliance plan.
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