Premier Comments on Proposed New Standards for Healthcare Data Transactions

Premier submitted comments to the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) on a proposed rule to adopt standards for data transactions to support electronic prior authorization and healthcare claims transmission processes. The proposed rule seeks public comment on HHS’ proposals to adopt standards for “healthcare attachments” transactions, which would support both healthcare claims and prior authorization transactions, and a standard for electronic signatures to be used in conjunction with health care attachments transactions. To better support the use of the proposed standards for attachments transactions with prior authorization transactions, the proposed rule also proposes to adopt a modification to the standard for the referral certification and authorization transaction (X12 278) to move from Version 5010 to Version 6020.

In its comments, Premier expressed appreciation for CMS’ commitment to enabling more efficient data exchange among providers, patients and payers, as evidenced by the proposed policies in this rule. Specifically, Premier recommends that CMS:

• Finalize proposed standards for health care attachment transactions and electronic signatures, as well as the proposed updated referral certification and authorization transaction standards, and
• Commit to implementing the Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR) standard by Jan. 1, 2026 to align with implementation of the proposals in the CMS proposed rule on advancing interoperability and streamlining prior authorization processes (CMS-0057-P).