The Standard

Upcoming Da Vinci Community Roundtable on April 29 at 4:00 pm ET

The momentum for healthcare interoperability continues to accelerate. Following the CMS-0057-F final rule, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) have introduced its next major regulatory step: the 2026 Interoperability Standards and Prior Authorization for Drugs Proposed Rule (CMS-0062-P).

Join the HL7 Da Vinci Project for the April Community Roundtable happening on Wednesday, April 29, 2026 at 4 p.m. ET as we break down this new proposal and discuss its implications for HL7 Fast Healthcare Interoperability Resources® (FHIR®) implementation and the industry at large. The new proposed rule relies heavily on the work of the HL7 Da Vinci Project community and could bring significant changes for industry, including adding Da Vinci implementation guides to Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements.

Featured Speakers

• Denise St. Clair: HL7 Da Vinci Project PMO; Vice President, Health Policy & Interoperability, Global Alliant, Inc.
• Alix Goss: Program Manager, HL7 Da Vinci Project; Senior Consultant, Point-of-Care Partners
• Moderator: Casey Thompson: HL7 Da Vinci Project Program Coordinator; Consultant, Point-of-Care Partners

Join Us for the January Da Vinci Project Community Roundtable on January 28, 2026, from 4 - 5:30 pm ET

As we enter 2026, the healthcare industry continues to move from planning to active implementation of standardized data exchange. Because the first phase of the CMS-0057-F Interoperability and Prior Authorization Final Rule took effect this month, the stakes for technical and operational alignment have never been higher. The HL7 Da Vinci Project Community Roundtable, taking place on January 28, 2026, from 4 – 5:30 pm. ET,  will provide insights and resources to navigate this pivotal year.

What You'll Learn

Our previous sessions focused on how using Da Vinci burden reduction and payer data exchange IGs are transforming healthcare and how best to meet prior authorization regulatory requirements. This January session builds on that foundation by outlining key use cases, IGs, and the progress made in standardized data exchange.

Gain valuable knowledge on operational enhancements and resources to optimize your planning for smoother HL7 FHIR implementations, including implementation guides referenced in federal regulations. Additionally, hear about Da Vinci's 2026 priorities and the HL7 Da Vinci Community Champions program. 

August Community Roundtable Provides Multi-Faceted View of Prior Authorization Regulatory Requirements and Da Vinci Implementation Resources   

For the August HL7 Da Vinci Project Community Roundtable, industry leaders will offer an insightful, holistic discussion targeting those who want to better understand how best to meet prior authorization regulatory requirements aiming to increase efficiency and improve patient outcomes.   

With a focus on the latest developments surrounding the Da Vinci Prior Authorization Implementation Guides (IGs), the session begins with an examination of clinical and business drivers and a level-setting overview of federal and state level-activities impacting prior authorization requirements. Then we highlight technical standards, focusing on the underlying requirements of CMS-0057,  HTI-4 and the current status of the IGs.  The session concludes with how Da Vinci responds to industry needs, fostering a supportive environment for implementation and providing education, resources, and learnings from real-world implementers and piloting opportunities for those on their implementation journey. 

The U.S. Department of Health and Human Services (HHS), in collaboration with over 45 of the nation’s largest health insurers, has announced an important step forward in transforming the problematic processes of prior authorization. By pledging to reduce delays, increase transparency, and standardize processes by 2027, these organizations have signaled a long-overdue shift toward easing administrative burdens and improving access to evidence-based care.

The pledge spans insurance markets (commercial coverage, Medicare Advantage and Medicaid managed care) and will benefit an impressive 257 million Americans. But turning that vision into reality will require more than declarations. It will demand the kind of trusted technical infrastructure that HL7’s community has built together for over 35 years.

 As implementation begins, prior authorization reform demands scalable, open and consensus-driven standards.

How AI for Deterministic Approaches Can Fix PA Denials

A recent survey by the American Medical Association (AMA) revealed a growing concern among physicians: over 60% believe that unregulated AI tools are systematically denying necessary patient care. “Emerging evidence shows that insurers use automated decision-making systems to create systematic batch denials with little or no human review, placing barriers between patients and necessary medical care,” said AMA President Bruce A. Scott, MD, reacting to the survey results.

This alarming trend exacerbates the already burdensome prior authorization (PA) process in the US, delaying essential treatments and placing undue strain on providers, payers and patients alike.

At Smile Digital Health, we believe that AI should support—not override—good medical judgment. That’s why we developed KALM Services (Knowledge Authoring Lifecycle Management), with AI capabilities designed to exponentially accelerate the creation of deterministic computable policies for prior authorization workflows and other use cases like clinical reasoning and quality measure evaluations.

Are you a member of a technical team that’s beginning its journey toward implementing HL7's Fast Healthcare Interoperability Resources (FHIR^®) application program interfaces (APIs)? Then don’t miss an upcoming three-day online educational event offering two technical tracks tailored to your needs. 

Two days of interactive content delivery and demonstrations will be followed by a Connectathon that will provide implementers and developers with the opportunity to test FHIR-based solutions and exchange data with other FHIR interfaces.  

Organizations that want to fast-track implementing HL7 FHIR APIs to automate workflow, maximize efficiency and meet federal requirements of the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) should encourage their technical teams attend this online event. 

“We designed two tracks for technical team members at provider and payer organizations, as well as technology vendors, who are looking for a crash course on making the most of FHIR,” says Viet Nguyen, M.D., Technical Director of the HL7 Da Vinci Project. (Da Vinci has developed implementation guides for putting FHIR to use in supporting value-based medicine.) 

Early Bird Registration Ends Soon

Time is running out to take advantage of early bird registration discounts for an upcoming three-day online educational event that will offer practical insights on how to implement Health Level Seven's (HL7®) Fast Healthcare Interoperability Resources (FHIR®) application program interfaces (APIs).

Early bird discounts end March 31 for the event, “Strategy to Execution: Better Prior Authorization by Integrating Operations, FHIR and CMS-0057.”

Two days of interactive content delivery and demonstrations will be followed by a collaborative Connectathon testing event on day three that will provide implementers and developers with the opportunity to test FHIR-based solutions and exchange data with other FHIR interfaces.

If you’re looking to fast-track your organization’s efforts to use HL7 FHIR APIs to automate workflow, maximize efficiency and meet federal requirements of the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F), then don’t miss this virtual, hands-on training and testing event.

March 26 Session Features Demonstration and Lessons Learned from Cognizant and Infor

What’s the most effective way to streamline the exchange of data among providers and payers for a wide variety of purposes? Find out at the next HL7 Da Vinci Project Community Roundtable: “Transforming Healthcare End-to-End Data Conversations.”

This free webinar, to be held at 4 p.m. ET on March 26, will show how two Da Vinci member organizations are working together to transform provider/payer data conversations by applying Health Level Seven's (HL7®) Fast Healthcare Interoperability Resources (FHIR®) application programming interface (API) standard.

In addition to a demonstration, presenters will address the lessons learned so far in using the FHIR Implementation Guides for Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR), Prior Authorization Support (PAS), Clinical Data Exchange (CDex), and Data Exchange for Quality Measures (DEQM), including Gaps in Care.  

One of the most efficient ways to exchange data among providers and payers for prior authorization and other purposes is by taking advantage of standard application program interfaces (APIs) and a central hub to avoid manual processes and support of point-to-point interfaces.

The HL7^® Da Vinci Project’s new Trebuchet pilot program, launched earlier this year, is enabling additional pioneers to test that approach.

Trebuchet was created when Da Vinci members Regence, MultiCare Connected Care, and Blue Cross Blue Shield Arkansas sought ways to pilot Da Vinci use cases on the emerging TEFCA framework. They contacted multiple Qualified Health Information Networks™, or QHINs™, to gauge their interest in joining the pilot. eHealth Exchange joined the effort to perform the QHIN functions and provided valuable project management support.

The team named the coalition “Trebuchet” to illustrate how the success of a third-century military catapult could inspire providers, payers, and a QHIN to accelerate trusted and scalable exchange. 

As efforts advanced and participants increased, Trebuchet asked Da Vinci to take over project management. Now a priority project adopted by Da Vinci, Trebuchet is proving how eHealth Exchange’s nationwide trust model and “Networked FHIR” architecture rapidly deploy Smart-on-FHIR Prior Authorization and Clinical Data Exchange (CDex) at scale

May 29 Sessionfeatures athenahealth, Availity and Humana and honors HL7 Da Vinci Project Community Champions from 4:00 - 5:30 pm ET

Join us this month to hear real-world HL7 FHIR and Da Vinci implementation stories that will provide you with inspiration and insight into how you can apply the learnings of athenahealth, Availity and Humana to your organization’s efforts to reduce friction, increase efficiency and meet the federal interoperability rules. 

After recognizing the 2023 HL7 Da Vinci Project Community Champions, representatives of Availity and Humana will provide a current snapshot of Da Vinci’s effort to create a nationwide interoperable approach among payers using the Payer Data Exchange (PDex) Implementation Guide, which enables payers to create a member’s health history using clinical resources which can be understood by providers and electronic medical records (EMR) systems. This discussion provides an opportunity to better understand dynamics you’ll encounter in achieving payer-to-payer exchange compliance such as consent and endpoint discovery.  Attendees will gain a foundational understanding of the new regulatory requirements, learn about technical and business challenges and benefits from real-world implementers and gain insight into how industry is working together.