Recorded webinar · April 28, 2026 · 12:00–1:00 PM ET

CMS-0057 Prior Authorization

Who builds what, who's liable, and how to be ready by January 2027

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Agenda

12:00–12:05

The accountability gap

Who owns PA compliance when execution is delegated and what happens when a delegate is not FHIR-ready.

Mike Kulakov

Product Manager

Health Samurai
12:05–12:20

Why Three IGs? What CRD, DTR, and PAS each solve?

The business logic behind the split. How the three IGs fit together as an end-to-end system. Where the spec is prescriptive vs. where implementers have room.

Lloyd McKenzie

Technical Director

HL7 Da Vinci Project
12:20–12:30

Payer Expectations Framework

A practical framework for aligning payer and delegate responsibilities in CMS-0057 prior authorization.

Mike Kulakov

Product Manager

Health Samurai
12:30–12:40

Lessons From a Delegate in Active Implementation

Building CRD, DTR, and PAS now — ahead of payer demand. What's working, what isn't, and what they'd do differently.

Phil Goldenberg

Chief Information Officer

Integrated Home Care Services (IHCS)
12:40–12:50

Implementation Architecture: FHIR APIs and Operational Compliance

How to connect CRD/DTR/PAS to a legacy UM system with no native FHIR support. Out-of-the-box vs. custom build tradeoffs.

Rajeev Ranjan

Vice President - Healthcare Technology Solutions

Emids

Rostislav Antonov

Software Engineer

Health Samurai
12:50–13:00

Q&A

All speakers, moderated.

From Compliance Obligation to Operational Reality

Payers are regulated under CMS-0057-F. But most prior authorization runs through delegated entities and UM vendors. When a delegate doesn't have compliant FHIR APIs — the payer is non-compliant. This is the accountability gap. And January 2027 is nine months away.

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Payer CIOs & VPs of Interoperability

Responsible for delegate compliance and FHIR API readiness.

Delegated entities & UM vendors

Building toward CMS-0057 prior authorization APIs.

Compliance & technology leaders

Who need a clear decision framework before January 2027.