AI in Healthcare by Case Health AI

CMS-0057-F and Medicare Advantage Prior Authorization


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📌 Overview:
In this episode, we break down the new CMS-0057-F Final Rule and what it means for Medicare Advantage plans. From faster prior authorization decisions to mandatory FHIR-based APIs, we cover the biggest changes, the 2026–2027 compliance deadlines, and the operational and technical steps plans need to take. Whether you're on the product, compliance, or engineering team, this is your guide to understanding what’s coming—and how to stay ahead of it.

🔍 Topics Covered:

  • What CMS-0057-F is and why it matters

  • New turnaround times for prior auth requests

  • Required API implementations and data standards

  • Reporting obligations and transparency rules

  • Practical steps payors can take to get ready

🎧 Who Should Listen:
Healthcare execs, payor compliance teams, product managers, and healthtech developers supporting MA organizations.

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AI in Healthcare by Case Health AIBy Case Health AI