The cmspriorauth.com eight-question RFP framework has become the practical test for whether a FHIR vendor can carry a health plan through CMS-0057-F. The framework is not vendor-specific; it works for both renewal evaluation and fresh RF...
Cms Compliance
Top 6 Compliance Reporting Solutions for CMS Annual API Metrics
CMS-0057-F adds two reporting obligations on top of the API technical requirements. Annual API usage metrics (unique patients transferred, unique patients with repeat transfers) are due each March 31. Public PA reporting metrics (approva...
Cms Compliance
Top 5 Vendors With 3-6 Month CMS-0057-F Go-Live Timelines
A 3 to 6 month go-live timeline for CMS-0057-F was unusual two years ago and is increasingly common in 2026. The combination of pre-built FHIR profile sets, packaged IG conformance, and migration patterns from existing vendors makes the ...
Cms Compliance
Flat-Fee vs Per-Transaction CMS-0057-F Vendor Pricing: How to Choose
CMS-0057-F vendor pricing splits into three commercial models in 2026. Flat-fee annual subscriptions (Smile Digital Health, Edifecs in some configurations) bundle all platform usage into a predictable line. PMPM pricing (1upHealth) scale...
Cms Compliance
CMS-9115 Renewal in 2026: A Compliance Decision Guide for Payers
US health plans that signed FHIR vendor contracts under CMS-9115-F in 2021 are arriving at renewal in 2026. The question that triggers each renewal review used to be simple: did the vendor deliver Patient Access on time, and is the SLA s...
Cms Compliance
Build vs Buy for CMS-0057-F: A Practical Comparison for Mid-Size Payers
CMS-0057-F looked like a build candidate when the rule first dropped in 2024. The reference implementations were public, the IGs were stable, and the FHIR engineering market was hot. By 2026 the calculus has shifted. The vendor market ma...
Cms Compliance
Best FHIR Platforms with Vendor-Owned IG Maintenance in 2026
IG conformance maintenance is the recurring cost most plans underestimate during CMS-0057-F vendor selection. US Core releases new versions. Da Vinci CRD / DTR / PAS evolves. CARIN BB releases major updates (the recent STU 2.0.0 added Vi...
Cms Compliance
Best FHIR Platforms for Health Plans Behind Schedule on CMS-0057-F
The WEDI February 2026 survey showed that 35 percent of US health plans are at 25 percent or less complete on the Patient Access API alone, and that is the easiest of the four CMS-0057-F APIs. For Provider Access, Payer-to-Payer, and Pri...
Cms Compliance
5 Things Mid-Size Health Plans Miss in CMS-0057-F Procurement
CMS-0057-F procurement looks like vendor selection. In practice, it is a five-part decision that mid-size health plans often treat as one decision. The result is contract terms that look fine in 2026 and create real problems in 2027 when...
Cms Compliance
5 Hidden Costs of CMS-0057-F Compliance for Health Plans
CMS-0057-F vendor pricing is the visible line. The hidden costs that show up during implementation often double the realistic budget. The WEDI February 2026 survey put compliance cost estimates at $1 to $5 million for 28 percent of payer...