The Federal Government Signals It’s All In on CMS-0057 and Interoperability

Since the November 2024 elections, one of the most common questions we’ve heard from customers, prospects, and even some industry veterans is: What will the Trump administration do with CMS-0057? Will it delay enforcement? Will it pivot to something else? Or will it double down?

While CMS hasn’t directly commented on CMS-0057 timing or enforcement, the signals are loud and clear.

The Federal Government Has Two Feet on the Gas

On May 16, 2025, CMS, ASTP/ONC, and HHS released a Request for Information (RFI) seeking public input on the state of digital health products for Medicare beneficiaries and the broader health IT infrastructure. It called for feedback that would help guide the government’s work in modernizing health data exchange, improving digital access for patients, and building infrastructure that supports transparency and outcomes.

This wasn’t just a nod to innovation or regulation — it was an important signal that data modernization and interoperability are central to the administration’s healthcare strategy. The RFI focused not only on patient empowerment through data, but also on catalyzing better decision-making through expanded access to relevant, actionable information.

The Listening Session That Left No Doubt

That direction became even more concrete during the June 3, 2025 joint RFI Listening Session hosted by CMS and ASTP/ONC and sponsored at the highest level by HHS Secretary Robert F. Kennedy, Jr. and CMS Administrator Dr. Mehmet Oz. The event’s agenda read more like a political and technological summit than a routine public meeting.

Attended by key luminaries in health IT, the day featured high-profile panels, covering themes such as:

• Connecting the Dots for Patients and Providers
• Value-Based Care: Access, Economics, and APIs
• Unleashing the Digital Health Ecosystem

What stood out most was the announcement of five major CMS/ONC/ASTP initiatives:

1. A national healthcare directory for API endpoints
2. Expanded focus on Member Identity Solutions, including ID verification technologies
3. Enhancements to the Patient Access API, including support for digital insurance cards and additional data classes
4. The general availability of the Data at the Point of Care (DPOC) API
5. CMS taking the lead and participating directly in national data exchange programs

These initiatives signal more than policy continuation. They represent a bold escalation in pace, scope, and federal commitment to the principles behind CMS-0057.

A Blueprint for Administrative Simplification

Just days after the listening session, the administration made even bigger news: the Industry Pledge to Fix Prior Authorization, a long-standing pain point in healthcare. Backed by HHS and featuring major payer organizations that cover 75% of American lives, the pledge outlines a set of meaningful commitments to:

• Use FHIR-based APIs for standardized prior authorization submissions
• Reduce the number of services requiring prior authorization by 2026
• Honor existing authorizations when members switch plans
• Increase real-time approvals by 2027
• Ensure clinical review of all denials

In a press event, Dr. Oz described the initiative as more than just a fix for prior authorization. It’s the template for modernizing healthcare administration — a shift to digital-first, standards-based data exchange that puts patients over paperwork.

His words were especially powerful:

“We are going to use this as the first and very important step in building a larger blueprint. Because it’s not just about Prior Authorization. It’s a template for administrative simplification… a standardized way for information to get exchanged across systems.”

The Big Picture: Interoperability is the Strategy

Across every one of these events and announcements, a few themes are crystal clear:

• There is 100% alignment — from the White House, HHS, CMS, and ONC — on making interoperability, administrative simplification, and digital modernization core federal healthcare priorities.
• FHIR is not just a standard — it’s the infrastructure.
• API endpoints must be discoverable, usable and valuable — a clear indicator that passive compliance won’t cut it. CMS intends to monitor and push for real results.
• Information blocking enforcement is increasing. The days of optional participation are over.

What It Means for Health Plans and Providers

If you’re a payer, CMS-0057 is now a mandate you can’t afford to ignore. If you’ve been on the sidelines, waiting for signals that the CMS-0057 final rule will be upheld, you’ve now got your answer. 

The administration has made its position clear. CMS-0057, with its focus on FHIR APIs for interoperability and prior authorization, is not going away. It’s the cornerstone of a long-term plan to fix how healthcare data is exchanged and used in the U.S.

They’ve gone from signaling support to taking concrete action. Now it’s time for the rest of the ecosystem – plans, providers, and vendors – to follow suit. This is the baton-passing moment. The infrastructure is being laid. The policies are aligning. The incentives are taking shape.

Now, it’s our job to take the baton and keep on running.

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