Availity Advances Multi-Payer Interoperability Network

Sept. 29, 2026 - Availity, the nation’s largest health information network, today announced progress toward building a multi-payer FHIR interoperability network designed to support the API requirements of the CMS Interoperability and Prior Authorization Final Rule, CMS-0057-F.

By providing a shared connectivity layer across payers, providers, health systems, EHRs, HIT organizations and other partners, the Availity Network is designed to reduce the number of point-to-point connections healthcare organizations must build and maintain. The network centralizes connectivity, authentication, onboarding, routing, testing and support, which is intended to help lower implementation effort and support reliable connectivity through Availity’s infrastructure and security posture.

“Healthcare organizations do not just need standards-based APIs. They need a reliable way to connect those APIs across the many organizations involved in healthcare transactions,” said Sean Barrett, Chief Product Officer at Availity. “Our strategy is to provide a multi-payer FHIR interoperability network that reduces the need for organizations to establish and maintain each connection individually.” 

A Network Designed to Support the CMS-0057-F API Requirements

CMS-0057-F requires impacted payers to implement and maintain standards-based APIs that expand access to health information and improve prior authorization and data exchange. Impacted payers have until primarily January 1, 2027 to meet the rule’s API requirements. 

Availity’s CMS-0057-F API portfolio is designed to support CMS-0057-F API requirements across three exchange areas with an emphasis on data exchanges across the full healthcare ecosystem:

• Provider Access API, supporting payer-to-provider exchange of patient data for treatment and care coordination.
• Prior Authorization API, supporting electronic prior authorization workflows and the exchange of information required to complete authorization requests.
• Payer-to-Payer API, supporting the exchange of patient information between current and previous payers to help maintain continuity of data.

Together, Availity’s portfolio and network model are intended to give healthcare organizations one connection through which they can reach multiple participating organizations, rather than requiring separate integrations for each trading relationship.

Prior Authorization Testing Demonstrates the Need for Operational Readiness

Availity tested standards-based prior authorization workflows during HL7 FHIR Connectathons in recent months. Twenty-seven organizations participated in testing with Availity across submitter, receiver, and intermediary roles. Participants successfully completed prior authorization workflow scenarios using:

• CRD (Coverage Requirements Discovery)
• DTR (Documentation Templates and Rules)
• PAS (Prior Authorization Support)

The testing results indicated that the underlying standards can support electronic prior authorization workflows. It also reinforced that standards alone do not determine whether exchange will work at scale. Differences in operational readiness, connectivity, test environments, and workflow integration affect how quickly organizations can move from technical implementation to reliable operational exchange.

“The Da Vinci standards establish a foundation, but scale depends on how effectively organizations connect those standards to their workflows and to one another,” said Barrett. “The work happening through our Connectathon and cohort testing is helping Availity identify what healthcare organizations need to move from individual API deployments to dependable exchange at scale. As a multi-payer network, we can identify and address differences in how organizations interpret and implement the standards, helping reduce complexity so payers and providers can focus on patient care rather than API maintenance and data exchange.”

Moving From API Implementation to Connected Exchange

As healthcare organizations prepare for CMS-0057-F, successful implementation will require more than deploying APIs independently. Organizations must be able to discover one another, establish trusted connections, route information, test exchange scenarios, and support transactions reliably across different systems and workflows.

By combining a CMS-0057-F API portfolio with multi-payer connectivity and shared services for onboarding, authentication, routing, testing and support, Availity is building a FHIR interoperability network intended to reduce point-to-point complexity and help participating organizations advance toward exchange at scale.

“Interoperability succeeds when the industry tests together, learns together and connects together,” said Sean Barrett. “Our progress this year is an important step toward a network that can support CMS-0057 requirements while helping healthcare organizations build a more connected foundation for future exchange.”