FHIR Foundry Ecosystem to Improve Conformance with CMS Final Rule

The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) represents a significant step forward in the healthcare industry’s ongoing efforts to enhance data exchange and streamline prior authorization processes. Most significantly, the rule aims to simplify prior authorization processes, making it quicker and easier for providers to obtain necessary approvals. This can lead to faster patient access to care and reduce the time clinicians spend on administrative tasks. Interoperability is enhanced by mandating the implementation of HL7® FHIR® APIs (Application Programming Interfaces) by Medicare Advantage organizations, Medicaid, CHIP and QHP issuers on FFEs. This interoperability is vital for improving patient outcomes and reducing administrative burdens. Establishing a standard and providing a regulatory driver are important aspects in the adoption of prior authorization interoperability. This presentation discusses the vision of the HL7 FHIR Foundry, a discovery and testing ecosystem that would allow implementers to search for reference implementations based on implementation guides, host applications, and perform robust interoperability testing. The work done so far by HL7 International in achieving the vision of the HL7 Foundry, challenges faced, and the future efforts that are being made to involve the broader FHIR community are also addressed in this presentation.