Swift Revalidation of High-Risk Medicaid Providers, National Directory, and Payer APIs
On April 23, 2026, CMS Administrator Dr. Mehmet Oz sent letters to every governor and state Medicaid director, directing states to conduct
Category: Policy and Regulation
REAL Health Providers Act: How should we measure accuracy?
In May 2023, staff from the Senate Finance Committee called 120 mental health providers listed as in-network across twelve Medicare Advantage plans.
CMS embraces Bulk FHIR Publish for Medicare Plan Finder
CMS released updated technical guidance (look at the three files with ‘provider directory’ in their file name in the zip file) on
CMS-0062-P and What Mandatory Payer API Endpoint Reporting Means for Provider Directories
On April 10, CMS released a new proposed rule CMS-0062 with electronic prior authorization for drugs as the centerpiece. Brendan Keeler has an
MA Plan Finder: Technical Guidance and Timeline Explainer
** This post was updated on 2/27/2026 to reflect CMS’s final technical guidance and timelines On November 7 2025, CMS released a
REAL Health Providers Act passed
The REAL Health Providers Act was passed as part of the Consolidated Appropriations Act, signed by President Trump on February 3, 2026.
MA Plan Finder: A Dress Rehearsal for National Provider Directory
On September 19, 2025, CMS issued a Final Rule requiring Medicare Advantage (MA) plans to submit provider directory data to CMS in
CMS Health Tech Ecosystem RFI: National Directory Comments
In its recent Request for Information (RFI) on the Health Tech Ecosystem, CMS posed questions about the value and feasibility of a
How will the CMS National Directory affect health plans?
CMS announced on June 3, 2025 plans to build a National Directory of Healthcare (NDH). While the directory’s long-term vision includes both
Notes from the CMS and ASTP/ONC RFI Meeting in Washington, DC
I attended the CMS and ASTP/ONC RFI meeting, which drew 300+ participants from across the healthcare industry. Participants included tech vendors, providers,