CMS Interoperability & Prior Authorization Rule
The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F), finalized in 2024, requires impacted US payers — Medicare Advantage, Medicaid, CHIP, and ACA exchange plans — to build FHIR APIs for patient access, provider access, payer-to-payer exchange, and, most notably, an electronic Prior Authorization API based on the HL7 Da Vinci implementation guides. With compliance dates in 2026–2027, it is the regulation pulling the payer and prior-authorization side of US healthcare onto FHIR.
Regions
Industries
Each links to that industry as a scored cohort — so the question "how ready is this sector for the regime that governs it?" becomes one you can actually look at.
Implemented by these standards
A regulation is the law; a standard is the machine-readable contract that satisfies it. Almost every regime in this catalog restricts an interface rather than requiring one — where a standard exists, it is the part a provider can actually publish.