Agentic Healthcare by Case Health AI
CMS-0057-F and Medicare Advantage Prior Authorization
07 May 2025
๐ Overview:In this episode, we break down the new CMS-0057-F Final Rule and what it means for Medicare Advantage plans. From faster prior authorization decisions to mandatory FHIR-based APIs, we cover the biggest changes, the 2026โ2027 compliance deadlines, and the operational and technical steps plans need to take. Whether you're on the product, compliance, or engineering team, this is your guide to understanding whatโs comingโand how to stay ahead of it.๐ Topics Covered:What CMS-0057-F is and why it mattersNew turnaround times for prior auth requestsRequired API implementations and data standardsReporting obligations and transparency rulesPractical steps payors can take to get ready๐ง Who Should Listen:Healthcare execs, payor compliance teams, product managers, and healthtech developers supporting MA organizations.
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