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Healthcare Interoperability and Regulatory Trends: A Review of FHIR and CMS Developments

April Monthly Review: Undeprecated Edition - Health API Guy

May 7, 2026

Summary

This monthly review summarizes several key developments concerning electronic health records and data sharing in the US. Key regulatory trends include new proposed rules from CMS regarding drug prior authorization, and legal disputes surrounding the definition of Health Information Networks (HINs), focusing heavily on interoperability issues.

Details

This review provides a comprehensive roundup of recent advancements in U.S. healthcare IT, covering regulation, litigation, and interoperability. Key topics include CMS' proposed rule for drug prior authorization, where the choice of standard will significantly impact the pharmacy ecosystem. Furthermore, legal issues are surfacing regarding the definition of Health Information Networks (HINs) and how state Immunization Information Systems (IIS) are treated. Other notable points include OPM's plan for large-scale medical record data collection across FEHB, and internal tensions within CMS between legacy HIPAA transaction teams and FHIR-native interoperability teams appearing in the rule text. In litigation, major vendor disputes like Veeva v. Epic continue, deepening substantive arguments about interoperability and data access. These developments are crucial elements shaping the future of medical data standardization and flow in the United States.

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