Comment on CMS-2026-1255-0001
Defacto Health LLCSupportBusiness
Summary: Defacto Health LLC, a healthcare data company, supports the proposed mandatory payer API endpoint reporting requirements and argues that they are a necessary step for creating a functional National Provider Directory. The company recommends expanding the scope of reporting to include more data endpoints (such as QHP and MA Plan Finder directories), requiring stable plan identifiers, extending usage metrics, and establishing a public issue registry for reporting broken endpoints.
Defacto Health LLC submits the attached comments in response to CMS-0062-P, Medicare and Medicaid Programs; Electronic Prior Authorization for Drugs. Our comments focus on the proposed mandatory payer API endpoint reporting requirements and offer recommendations for expanding their scope, strengthening identifier requirements, extending usage metrics reporting, and establishing a public endpoint issue registry. We appreciate the opportunity to comment and welcome further engagement with CMS on these issues.