CMS-0057-F

42 CFR Parts 422, 431, 438, 457

ONC Cures Act

45 CFR Part 170 & USCDI v3

HIPAA

45 CFR 164 Security Rule

Information Blocking

45 CFR Part 171 Compliance

HL7 Standards

FHIR R4, US Core 6.1.0, Terminology 5.5.0

CMS Interoperability and Prior Authorization Final Rule

CMS-0057-F | Federal Register 89 FR 8758 | Published February 8, 2024

The CMS Interoperability and Prior Authorization Final Rule requires impacted payers to implement FHIR-based APIs for patient access, provider access, prior authorization, and payer-to-payer data exchange. Compliance deadline: January 1, 2027.

Applicable CFR Citations

CFR Citation Requirement InteropSuite Support
42 CFR 438.242(b)(5) Patient Access API - FHIR R4 with US Core profiles FHIR bundle generation
42 CFR 438.242(b)(6) Provider Access API - Clinical and claims data exchange FHIR bundle generation
42 CFR 438.242(b)(7) Prior Authorization API - Da Vinci PAS profiles FHIR bundle generation
42 CFR 438.242(b)(8) Payer-to-Payer API - PDex profiles Provenance source tracking
42 CFR 438.210(d) Prior authorization decision timeframes (7 days standard) API requirement
42 CFR Part 422 Medicare Advantage Organizations FHIR bundle generation
42 CFR Part 431 State Medicaid Agencies FHIR bundle generation
42 CFR Part 457 CHIP Managed Care Entities FHIR bundle generation
45 CFR Part 156 QHP Issuers on Federally-Facilitated Exchanges FHIR bundle generation
Implementation Note

InteropSuite is a transformation library that generates CMS-compliant FHIR bundles. You are responsible for implementing the FHIR server APIs and ensuring end-to-end compliance.

ONC 21st Century Cures Act & HTI-1 Final Rule

85 FR 25642 | 89 FR 1192 (HTI-1) | 45 CFR Part 170

The ONC Cures Act Final Rule and HTI-1 update establish standards for health IT certification, including FHIR-based APIs, USCDI v3 data classes, and US Core 6.1.0 as the baseline standard effective January 1, 2026.

HTI-1 Key Requirements (89 FR 1192)

Requirement Effective Date InteropSuite Support
USCDI v3 as baseline standard January 1, 2026 Full support
US Core IG 6.1.0 adoption January 1, 2026 All profiles
SMART App Launch 2.0.0 January 1, 2026 Server implementation

Applicable CFR Citations

CFR Citation Requirement InteropSuite Support
45 CFR 170.213 United States Core Data for Interoperability (USCDI) USCDI v3 compliant
45 CFR 170.215(a)(1) HL7 FHIR Release 4.0.1 Full support
45 CFR 170.215(b)(1)(ii) US Core Implementation Guide STU 6.1.0 All profiles
45 CFR 170.215(c)(2) SMART App Launch IG Release 2.0.0 Server implementation
45 CFR 170.315(g)(10) Standardized API for Patient and Population Services Data transformation

Information Blocking

45 CFR Part 171 | 21st Century Cures Act Section 4004

The Information Blocking Rule prohibits healthcare providers, health IT developers, and health information networks from practices that interfere with access, exchange, or use of electronic health information (EHI). InteropSuite enables compliant data sharing by transforming legacy formats to standardized FHIR.

How InteropSuite Helps Avoid Information Blocking

Information Blocking Practice How InteropSuite Helps
Technical barriers to access Transforms HL7 v2.x, X12, C-CDA to standardized FHIR R4
Non-standard data formats Outputs US Core 6.1.0 compliant resources
Inability to respond to data requests Enables real-time transformation for API responses
Limiting data to proprietary formats Converts to open FHIR standard

Applicable Exceptions (45 CFR 171 Subpart B)

CFR Citation Exception Relevance
45 CFR 171.201 Preventing Harm Exception Clinical decision - not affected by transformation
45 CFR 171.202 Privacy Exception InteropSuite processes locally, no PHI exposure
45 CFR 171.203 Security Exception AES-256-GCM encryption, audit logging
45 CFR 171.204 Infeasibility Exception InteropSuite makes FHIR transformation feasible
45 CFR 171.205 Health IT Performance Exception High-performance transformation engine
45 CFR 171.301 Content and Manner Exception Outputs in standard FHIR format

Enable Data Sharing, Avoid Information Blocking

By transforming legacy HL7 v2.x, X12, and C-CDA data to standardized FHIR R4 with US Core profiles, InteropSuite helps organizations meet their data sharing obligations and avoid information blocking violations.

HIPAA Security Rule

45 CFR Part 164 Subpart C | Security Standards for ePHI

The HIPAA Security Rule establishes national standards to protect electronic protected health information (ePHI) through administrative, physical, and technical safeguards.

Technical Safeguards (45 CFR 164.312)

CFR Citation Safeguard InteropSuite Architecture
45 CFR 164.312(a)(1) Access Control - Unique user identification Per-developer licensing
45 CFR 164.312(a)(2)(iv) Encryption and Decryption AES-256-GCM quarantine
45 CFR 164.312(b) Audit Controls Comprehensive audit logging
45 CFR 164.312(c)(1) Integrity - Protect ePHI from alteration Tamper detection
45 CFR 164.312(d) Person or Entity Authentication License key validation
45 CFR 164.312(e)(1) Transmission Security 100% offline processing

100% Offline - PHI Never Leaves Your Infrastructure

InteropSuite processes all data locally within your environment. No PHI is transmitted to external services, validation servers, or cloud endpoints. All profile specifications are embedded in the library.

HL7 Standards & Implementation Guides

Industry Standards for Healthcare Interoperability

Embedded Specifications

FHIR R4 4.0.1

Base HL7 FHIR specification

hl7.org/fhir/R4

US Core 6.1.0

US realm FHIR profiles

US Core IG

HL7 Terminology 5.5.0

Code systems and value sets

terminology.hl7.org

CARIN Blue Button 2.1.0

Consumer health data exchange

CARIN BB IG

Da Vinci PAS 2.0.1

Prior Authorization Support

Da Vinci PAS IG

Da Vinci PDex 2.1.0

Payer Data Exchange

Da Vinci PDex IG

Input Format Standards

Standard Version Coverage
HL7 v2.x 2.3 - 2.8 30 message types (ADT, ORU, ORM, SIU, MDM, VXU, RDS, RDE, DFT)
X12 5010 005010X 15 transaction types (837P/I/D, 835, 270, 271, 276, 277, 278, 834, 820, 275)
C-CDA R2.1 11 document types, 33 section mappers