CMS-0057 for Payer Organizations

Build Interoperability That Outlasts the Mandate

CMS-0057 is no longer a mandate to meet. It is a capability to build.

CMS estimates nearly $15 billion in annual savings from reducing prior authorization inefficiencies. But unlocking that value requires more than point compliance. Emids helps health plans operationalize CMS-0057 and build FHIR-first data exchange that scales across the healthcare ecosystem.

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The Challenge

The Complexity Isn’t the Regulation. It’s the Execution.

CMS-0057 converges patient access, provider workflows, payer-to-payer exchange, and electronic prior authorization into a single operating reality.

The challenge is aligning architecture, data, workflows, and governance to execute it sustainably. A fragmented approach may meet deadlines. It rarely creates scalable interoperability or reduces administrative friction.

The Emids Approach

Unified Interoperability, Not Point Compliance

With deep experience across CMS-9115, CMS-0057, TEFCA, Blue mandates, multiple payers, Utilization Management Vendors, and PBMs, Emids helps health plans:

FHIR-First Foundations

Go live on FHIR APIs without ripping out your core systems. We build interoperability layers designed for durability, not just deadline compliance.

End-to-End Prior Authorization

Automate the full ePA workflow across CRD, DTR, and PAS. Reduce manual touchpoints and get authorization decisions faster.

Payer-to-Payer Data Portability

Exchange member data across plans at scale. Meet portability requirements while building infrastructure that supports future mandates.

Reusable, Mandate-Ready Architecture

Decouple real-time APIs from legacy systems of record. Build once and comply across CMS mandates, and whatever comes next.

Proven Impact

From Mandate to Momentum

Partnership

Emids and Onyx Health Join Forces to Accelerate CMS Interoperability Compliance

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Case Study

Compliance with CMS Interoperability & Patient Access Final Rule

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Ready to Move Beyond Compliance?

Our focus is not point compliance. It is scalable, payer-grade interoperability. Schedule a conversation with an expert who has done this before.