A free, always-current calendar of every CMS-0057-F obligation — which requirements apply to which payer type, by what date, under which date semantics — each row traced to the Federal Register.
Final dates and proposed dates are shown distinctly. Managed-care obligations key to the rating period on or after the date — that distinction is in every row. Filter to your entity type to see only what applies to you.
| Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213) | CHIP fee-for-service | 89 FR 8758 |
| Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213) | CHIP managed care | 89 FR 8758 |
| Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213) | Medicaid fee-for-service | 89 FR 8758 |
| Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213) | Medicaid managed care | 89 FR 8758 |
| Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213) | Medicare Advantage (MA) | 89 FR 8758 |
| Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213) | QHP issuers on the FFEs | 89 FR 8758 |
| — | All impacted payers | 89 FR 8758 |
| — | All impacted payers | 90 FR 36536 |
| Annual public reporting of prior authorization metrics on payer website | CHIP fee-for-service | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | CHIP managed care | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | Medicaid fee-for-service | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | Medicaid managed care | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | Medicare Advantage (MA) | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | QHP issuers on the FFEs | 89 FR 8758 |
| Prior authorization decision timeframes (72 hours expedited / 7 calendar days standard) | CHIP fee-for-service | 89 FR 8758 |
| Prior authorization decision timeframes (72 hours expedited / 7 calendar days standard) | CHIP managed care | 89 FR 8758 |
| Prior authorization decision timeframes (72 hours expedited / 7 calendar days standard) | Medicaid fee-for-service | 89 FR 8758 |
| Prior authorization decision timeframes (72 hours expedited / 7 calendar days standard) | Medicaid managed care | 89 FR 8758 |
| Prior authorization decision timeframes (72 hours expedited / 7 calendar days standard) | Medicare Advantage (MA) | 89 FR 8758 |
| Specific reason for prior authorization denial (any communication channel) | CHIP fee-for-service | 89 FR 8758 |
| Specific reason for prior authorization denial (any communication channel) | CHIP managed care | 89 FR 8758 |
| Specific reason for prior authorization denial (any communication channel) | Medicaid fee-for-service | 89 FR 8758 |
| Specific reason for prior authorization denial (any communication channel) | Medicaid managed care | 89 FR 8758 |
| Specific reason for prior authorization denial (any communication channel) | Medicare Advantage (MA) | 89 FR 8758 |
| Specific reason for prior authorization denial (any communication channel) | QHP issuers on the FFEs | 89 FR 8758 |
| — | All impacted payers | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | All impacted payers | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | CHIP fee-for-service | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | CHIP managed care | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | Medicaid fee-for-service | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | Medicaid managed care | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | Medicare Advantage (MA) | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | QHP issuers on the FFEs | 89 FR 8758 |
| Patient Access API usage metrics — annual report to CMS | All impacted payers | 89 FR 8758 |
| Patient Access API usage metrics — annual report to CMS | CHIP fee-for-service | 89 FR 8758 |
| Patient Access API usage metrics — annual report to CMS | CHIP managed care | 89 FR 8758 |
| Patient Access API usage metrics — annual report to CMS | Medicaid fee-for-service | 89 FR 8758 |
| Patient Access API usage metrics — annual report to CMS | Medicaid managed care | 89 FR 8758 |
| Patient Access API usage metrics — annual report to CMS | Medicare Advantage (MA) | 89 FR 8758 |
| Patient Access API usage metrics — annual report to CMS | QHP issuers on the FFEs | 89 FR 8758 |
| — | All impacted payers | 91 FR 14350 |
| — | All impacted payers Proposed | 91 FR 19890 |
| Electronic Prior Authorization measure (MIPS Promoting Interoperability performance category and Medicare Promoting Interoperability Program) | Hospitals & critical access hospitals | 89 FR 8758 |
| Electronic Prior Authorization measure (MIPS Promoting Interoperability performance category and Medicare Promoting Interoperability Program) | MIPS-eligible clinicians | 89 FR 8758 |
| Patient Access API — prior authorization information | CHIP fee-for-service | 89 FR 8758 |
| Patient Access API — prior authorization information | CHIP managed care | 89 FR 8758 |
| Patient Access API — prior authorization information | Medicaid fee-for-service | 89 FR 8758 |
| Patient Access API — prior authorization information | Medicaid managed care | 89 FR 8758 |
| Patient Access API — prior authorization information | Medicare Advantage (MA) | 89 FR 8758 |
| Patient Access API — prior authorization information | QHP issuers on the FFEs | 89 FR 8758 |
| Payer-to-Payer API | CHIP fee-for-service | 89 FR 8758 |
| Payer-to-Payer API | CHIP managed care | 89 FR 8758 |
| Payer-to-Payer API | Medicaid fee-for-service | 89 FR 8758 |
| Payer-to-Payer API | Medicaid managed care | 89 FR 8758 |
| Payer-to-Payer API | Medicare Advantage (MA) | 89 FR 8758 |
| Payer-to-Payer API | QHP issuers on the FFEs | 89 FR 8758 |
| Prior Authorization API (CRD+DTR+PAS capability) | CHIP fee-for-service | 89 FR 8758 |
| Prior Authorization API (CRD+DTR+PAS capability) | CHIP managed care | 89 FR 8758 |
| Prior Authorization API (CRD+DTR+PAS capability) | Medicaid fee-for-service | 89 FR 8758 |
| Prior Authorization API (CRD+DTR+PAS capability) | Medicaid managed care | 89 FR 8758 |
| Prior Authorization API (CRD+DTR+PAS capability) | Medicare Advantage (MA) | 89 FR 8758 |
| Prior Authorization API (CRD+DTR+PAS capability) | QHP issuers on the FFEs | 89 FR 8758 |
| Provider Access API | CHIP fee-for-service | 89 FR 8758 |
| Provider Access API | CHIP managed care | 89 FR 8758 |
| Provider Access API | Medicaid fee-for-service | 89 FR 8758 |
| Provider Access API | Medicaid managed care | 89 FR 8758 |
| Provider Access API | Medicare Advantage (MA) | 89 FR 8758 |
| Provider Access API | QHP issuers on the FFEs | 89 FR 8758 |
| Annual public reporting of prior authorization metrics on payer website | All impacted payers | 89 FR 8758 |
| Patient Access API usage metrics — annual report to CMS | All impacted payers | 89 FR 8758 |
| Include a specific reason for denial in prior authorization responses for all drugs | Medicaid fee-for-service Proposed | 91 FR 19890 |
| Include a specific reason for denial in prior authorization responses for all drugs | Medicaid managed care Proposed | 91 FR 19890 |
| Include a specific reason for denial in prior authorization responses for all drugs | QHP issuers on the FFEs Proposed | 91 FR 19890 |
| Incorporate drugs covered under a medical benefit into the Prior Authorization API | CHIP fee-for-service Proposed | 91 FR 19890 |
| Incorporate drugs covered under a medical benefit into the Prior Authorization API | CHIP managed care Proposed | 91 FR 19890 |
| Incorporate drugs covered under a medical benefit into the Prior Authorization API | Medicaid fee-for-service Proposed | 91 FR 19890 |
| Incorporate drugs covered under a medical benefit into the Prior Authorization API | Medicaid managed care Proposed | 91 FR 19890 |
| Incorporate drugs covered under a medical benefit into the Prior Authorization API | Medicare Advantage (MA) Proposed | 91 FR 19890 |
| Incorporate drugs covered under a medical benefit into the Prior Authorization API | QHP issuers on the FFEs Proposed | 91 FR 19890 |
| Prior authorization decision timeframes for drugs | CHIP fee-for-service Proposed | 91 FR 19890 |
| Prior authorization decision timeframes for drugs | CHIP managed care Proposed | 91 FR 19890 |
| Prior authorization decision timeframes for drugs | Medicaid fee-for-service Proposed | 91 FR 19890 |
| Prior authorization decision timeframes for drugs | Medicaid managed care Proposed | 91 FR 19890 |
| Prior authorization decision timeframes for drugs | QHP issuers on the FFEs Proposed | 91 FR 19890 |
| Publicly report prior authorization metrics for drugs | Medicaid managed care Proposed | 91 FR 19890 |
| Publicly report prior authorization metrics for drugs | Medicare Advantage (MA) Proposed | 91 FR 19890 |
| Publicly report prior authorization metrics for drugs | QHP issuers on the FFEs Proposed | 91 FR 19890 |
| Report usage metrics for the Provider Access, Payer-to-Payer, and Prior Authorization APIs to CMS | Medicare Advantage (MA) Proposed | 91 FR 19890 |
| Report usage metrics for the Provider Access, Payer-to-Payer, and Prior Authorization APIs to CMS | QHP issuers on the FFEs Proposed | 91 FR 19890 |
| Support the NCPDP SCRIPT standard for electronic prior authorization of pharmacy-benefit drugs | Medicaid fee-for-service Proposed | 91 FR 19890 |
| Support the NCPDP SCRIPT standard for electronic prior authorization of pharmacy-benefit drugs | Medicaid managed care Proposed | 91 FR 19890 |
| Support the NCPDP SCRIPT standard for electronic prior authorization of pharmacy-benefit drugs | QHP issuers on the FFEs Proposed | 91 FR 19890 |
| Apply interoperability and prior authorization API requirements to small-group QHP issuers on the FF-SHOPs | QHP issuers on the FF-SHOPs Proposed | 91 FR 19890 |
| — | All impacted payers | 89 FR 8758 |
| Adopt HL7 C-CDA and HL7 Attachments IGs for claims-attachment content | HIPAA-covered entities | 91 FR 14350 |
| Adopt HL7 electronic/digital signature standard for attachments | HIPAA-covered entities | 91 FR 14350 |
| Adopt X12N 275 (006020X314) and X12N 277 (006020X313) as claims-attachment transaction standards | HIPAA-covered entities | 91 FR 14350 |
See only the obligations that apply to your organization, with their compliance dates and any extension or exemption paths named in the rule.
The deadlines above are public. What isn’t: which payers have already posted their prior-authorization metrics, and what they reported. Dataplex tracks that layer — human-reviewed and traced to each payer’s own published source.
Every key CMS-0057-F compliance date on a single printable page — what’s due, who it hits, traced to the Federal Register. We’ll email you the PDF and a note from our team.