event

ACAP is hosting a virtual Vendor Showcase for its member plans to provide its Safety Net Health Plans with tools and services that support implementation of CMS’s Interoperability and Prior Authorization Final Rule. The Showcase is scheduled to run May 5 – May 14, 2026.

The rule modernizes prior authorization by mandating electronic prior authorization workflows, setting clear decision timeframes, requiring specific denial rationales, and publicly reporting prior authorization metrics. In addition, the rule establishes payer-to-payer data exchange — subject to patient consent — so members’ clinical and administrative data can follow them when they change health plans, reducing duplicative requests and care disruptions. This showcase aims to help ACAP plans understand how they can meet these new interoperability, prior authorization, and data-sharing requirements through various mechanisms and strategies.

All sessions will be held from 12:00-1:00 p.m. ET.

Adapting to the New Interoperability & UM Landscape: From Regulatory Change to Operational Execution
Tuesday, May 5, 2026

CMS CY2027 interoperability and prior authorization requirements are driving a fundamental shift from policy-based compliance to real-time, data-driven operations. As FHIR-based APIs, electronic prior authorization, and expanded data exchange take hold, health plans must align technology, workflows, and clinical decision-making to keep pace.

In this session, Toney Healthcare experts will outline what’s changing, where plans are encountering challenges, and how to translate regulatory mandates into scalable operational execution. Attendees will gain practical strategies to modernize prior authorization, strengthen clinical oversight, and build the infrastructure needed to succeed in a more transparent, API-driven environment.

Learn more about Toney Healthcare’s Products and Services

Showcase Materials:
Slide Deck
Recording

Driving Compliance and Efficiency: Solutions for CMS Interoperability and Prior Authorization Final Rule
Monday, May 11, 2026

The CMS Prior Authorization Burden Reduction Final Rule, or CMS-0057, focuses on three pillars. It aims to improve secure data sharing, streamline prior authorization, and empower patient access. By January 1, 2027, health plans must securely share clinical and prior authorization data using standardized technology. HealthEdge experts will reveal the purpose-built, integrated end-to-end FHIR solution that helps health plan executives navigate data siloes, authorization inefficiencies, and compliance risks.

Learn more about HealthEdge’s Products and Services
Empowering Health Plans to Advance Care Management with GuidingCare
Future-Proof Your Health Plan with HealthEdge GuidingCare® — FHIR-Driven Solutions Enable Compliance
Modernizing Prior Authorization: A Critical Step Toward Delivering Higher-Quality Care
What’s Now & What’s Next: A Fireside Chat on Interoperability with GuidingCare Product Leader Bobby Sherwood
White Paper: Open & Flexible Care Management Systems to Transform Healthcare
Care Management Interoperability: FHIR and the HL7 Da Vinci Project at HealthEdge

Showcase Materials:
Please contact Allison Peterson for access to slide deck and recording link.

CMS-0057 Readiness: Reduce Risk, Avoid Rework, Build Beyond Compliance
Wednesday, May 13, 2026

WEDI’s latest survey shows CMS-0057 work is accelerating: the share of payers that had not started fell from 43% to 10% in just five months. Yet only 13% say they are at or near completion, and costs continue to rise.

For health plans, the challenge now is not just getting started. It is making the right decisions early enough to reduce risk, avoid rework, prepare for future mandates (such as the newly released CMS-0062-P), and build a foundation that supports more than compliance. With public reporting already live, CMS-0057 implementation has become a business-critical decision.

In this session, attendees will learn:

• Where plans stand today and where risk is increasing
• The implementation challenges most likely to slow progress or create rework
• How to approach CMS-0057 for long-term value, not just near-term compliance
• How Abacus and Onyx help plans move faster, reduce risk, and reduce total cost of ownership

Learn more about Abacus Insight’s Products and Services
CMS Interoperability: Turn interoperability compliance into a competitive advantage

Showcase Materials:
Slide Deck
Recording

Achieve CMS-0057-F (Interoperability & Prior Authorization) Requirements Without Replacing Core Systems: A Smarter Approach for ACAP Plans
Thursday, May 14, 2026

ACAP health plans must meet CMS-0057-F requirements without disrupting existing systems. This session shows a practical, low-risk approach to enable FHIR-based interoperability, streamline prior authorization, meet timelines, and improve transparency — without core system replacement. Learn how to achieve compliance faster while reducing administrative burden and operational complexity.

Learn more about Rovicare’s Products and Services

Showcase Materials:
Please contact Pankaj Likhmania for access to slide deck and recording link.