ONC Finalizes the Adoption of Certain Health IT Standards in the FY2027 CMS IPPS Final Rule

July 2026

Overview

The Office of the National Coordinator for Health Information Technology (ONC) partnered with CMS to finalize a series of health information technology (health IT) standards and specifications on behalf of HHS in the CMS FY 2027 Hospital Inpatient Prospective Payment System (IPPS) final rule (CMS-1849-F). These provisions were originally included as proposals in the 2026 CMS Interoperability Standards and Prior Authorization for Drugs (CMS-0062-P).

The standards ONC is adopting in the IPPS final rule support the interoperability of FHIR® APIs for: electronic prior authorization transactions; exchange of administrative and clinical data between payers and providers; sharing payer drug formularies; and sharing information about payer provider directories.

These standards are referenced in proposed requirements for payer Application Programming Interface (APIs) in the 2026 CMS Interoperability Standards and Prior Authorization for Drugs proposed rule. They are also referenced in ONC health IT certification criteria for electronic prior authorization. 

Adoption of Standards for Patient, Provider, and Payer APIs

ONC finalized the adoption of the following standards on behalf of HHS:

• HL7 FHIR® Da Vinci—Coverage Requirements Discovery IG [Implementation Guide], Version 2.2.1 – STU 2.2
• HL7 FHIR® Da Vinci—Documentation Templates and Rules Implementation Guide, Version 2.2.0 – STU 2.2
• HL7 FHIR® Da Vinci—Prior Authorization Support (PAS) FHIR Implementation Guide, Version 2.2.1 – STU 2.2
• HL7 FHIR® CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®) [Implementation Guide], Version 2.2.0 – STU 2.2
• HL7 FHIR® Da Vinci Payer Data Exchange (PDex) US Drug Formulary Implementation Guide, Version 2.1.0 – STU 2.1
• HL7 FHIR® Da Vinci PDex [Payer Data Exchange] Plan Net Implementation Guide, Version 1.2.0 – STU 1.2
• HL7 FHIR® Da Vinci Clinical Data Exchange (CDex) IG [Implementation Guide], Version 2.1.0 – STU 2.1

Where ONC previously adopted a version of one of these standards in the HTI-4 final rule (released in July 2025 as part of the FY 2026 IPPS final rule (CMS-1833-F)), ONC has finalized to replace previously adopted versions with the updated versions upon the effective date of the FY 2027 IPPS final rule (October 1, 2026).