What We Heard at MESC 2026: Medicaid Interoperability, Consent and Trusted Health Data Exchange
At MESC 2026, two things were top of mind for most attendees: implementation of HR-1, and CMS Interoperability. Many of our conversations about Medicaid interoperability focused on a practical question: what does it take to make health data exchange work across real organizations, networks and workflows? Consent. Identity. Security. Purpose of use. Attachments. Payer-to-payer exchange. None of these are new challenges. What stood out was how […]
What Black Book’s Payer Interoperability KPIs Tell Health Plans About Building for Evolving Mandates
Black Book’s 2026 payer interoperability research evaluated vendors across 18 key performance indicators, based on feedback from 764 qualified payer respondents. Onyx ranked #1 overall and earned the top score in 11 of the 18 KPIs. The 18 measures span much more than basic API functionality. They look at everything from regulatory readiness, standards conformance […]
When Members Search for Their Doctor, Will Your Plan Show Up?
Provider directory accuracy has always been hard. But for Medicare Advantage plans, CMS-4208-F2 changes the stakes. Under the CMS-4208-F2 final rule, MA organizations must make provider directory data available to CMS/HHS for use in Medicare Plan Finder, update that information within 30 days of known changes, and attest at least annually that the data is […]
Inside the Onyx CMS-0057 Playbooks
From Mandate to Measurable Value The Interoperability and Prior Authorization Final Rule CMS-0057 is reshaping how payers, providers, and patients exchange health data. It builds on CMS-9115 with expanded use cases, bi-directional APIs, and higher expectations across four tracks: Payer-to-Payer, Provider Access, Patient Access, and electronic Prior Authorization (ePA). Most provisions must be live by […]
Better Data = Better Care
We’re All In. A CMS-Aligned Network Yesterday’s announcement from The White House, U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services is a clear call to action: build health tech that actually works for the people who use it. At Onyx, we’re all in, guided by our purpose of […]
Onyx Health at the CMS July 2025 Connectathon: Demonstrating Real-World Readiness for CMS-0057
This week CMS held its sixth Connectathon, a three-day virtual event with 1,500 registered attendees. The Onyx team was there demonstrating OnyxOS and the capabilities that enable payers and providers to support the requirements of the CMS Prior Authorization regulation (CMS-0057).
What’s the difference between “Patient Access API” and “Provider Access API”?
The latest Proposed rule from CMS addressing Prior Authorization (December 13, 2022) also expands the Patient Access API and adds a Provider API. Provider Access API and Patient Access API are two types of application programming interfaces (APIs) that allow different types of users to access member health information. Both are based on HL7 Fast […]