This course offers in-depth training on the CMS Proposed Rule introducing new standards for electronic prior authorization and data exchange for Medicare Advantage, Medicaid, CHIP, and Qualified Health Plan issuers. Learn the latest requirements for HL7 FHIR APIs, API endpoint reporting, expanded prior authorization processes for drugs, and strengthened interoperability mandates. Gain actionable insights to ensure compliance, reduce administrative burden, and improve care coordination across impacted health care payers and providers.
In this course you will learn the following:
* Understand the purpose and intent of the proposed rule.
* Identify the key provisions and affected entities.
* Recognize the importance of public participation and feedback.
* Anticipate potential changes as the rule evolves.
* Analyze the expected impacts on health care data exchange and prior authorization.
