The Weekly

1/13/2025

New WEDI Interoperability and Prior Authorization Survey is Now Live!

WEDI is conducting a survey to determine how the health care industry is implementing the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule. Compliance with the Final Rule is required by Jan. 1, 2026, for the prior authorization metrics reporting and Jan.1, 2027 for the Interoperability and Prior Authorization API requirements. The following industry stakeholders encouraged to complete the survey: (i) Health plans; (ii) Providers; (iii) Clearinghouses; and (iv) Health IT vendors. The survey seeks to determine how the industry is implementing the CMS Final Rule one year after the regulation was finalized. The survey asks questions of stakeholders on key issues, including:

• Progress made on implementing the Payer-to-Payer, Provider Access, Patient Access, and Prior Authorization APIs.
• Will stakeholders not covered under the Final Rule be supporting the Interoperability and Prior Authorization APIs.
• Challenges encountered during the implementation process.
• Expected implementation costs.
• Resources necessary to assist implementation decisions and efforts.

The survey is open now and will close on Feb. 5. Results from the survey will be used to make recommendations to CMS, inform stakeholders, and assist WEDI in the development of industry guidance and education. No personally identifiable information will be collected or used.

From our Emerging Technology Workgroup - A Special Event

Thursday January 16th

3-4PM

This session will focus on AI automation of the prior authorization process and feature GenHealth AI. CEO Ricky Sahu will share how they utilize AI to automate health plan policies, extract meaningful data from the FHIR PAS API, execute review, and provide recommendations for clinical reviewers. As the industry works to streamline prior authorization, take this opportunity to gain insight from this Emerging Technology session.

This event is exclusive for WEDI Members.

Free to the Industry!

Join us for an in-depth spotlight designed for payers, providers, vendors, government, HIEs, SDOs, and more—focused on the latest developments in implementing the Payer-to-Payer API, Provider Access API, and Patient Access API from the CMS-0057-F Final Rule. As the health care landscape evolves toward greater interoperability, these APIs will be critical to facilitate seamless information exchange, improve patient care coordination, and support value-based care.

Winter Forum Discount Ends Friday

Join us for an engaging and informative Virtual Spotlight exploring how health care stakeholders—payers, providers, and innovators—are leveraging data and technology to bridge gaps in health care accessibility for under-resourced communities.

Use code "WINTERWEDI" for a 25% discount until FRIDAY January 17th, 2025

Registration Now Open!

Join the Conversation and Help Shape the Future of Cybersecurity!



In an era of rapid technological advancements and increasing digital connectivity, the health care industry faces an unprecedented wave of cybersecurity challenges. Join us for an insightful Virtual Spotlight as we explore the latest trends, threats, and solutions shaping the future of health care cybersecurity. 

New Fact Sheet from the Health Equity Workgroup!

This fact sheet outlines health equity and other sensitive patient data included in each version of the United States Core Data for Interoperability (USCDI), a baseline data set meant to set the floor for data exchange efforts in the United States. USCDI is an official government standard and is used to set requirements in various regulations related to health data and health data exchange.

WEDI, a national membership association since 1991, advises on health IT policy and implementation, focusing on enhancing health care through efficient data sharing and education across all stakeholders. Learn more about becoming a member here!

Connect, collaborate & communicate for a better health system