Federal & State Interoperability and Prior Authorization Project (FSIPAP)

The Washington State Health Care Authority is seeking market input on a statewide, FHIR‑based interoperability and prior‑authorization platform that will satisfy the CMS Interoperability and Prior Authorization Final Rule (CMS‑0057‑F). Vendors are asked to describe how they would deliver a solution that includes development of new Da Vinci‑compliant APIs, consent‑management capabilities, conversion of existing unstructured policy documents into computable FHIR artifacts, and integration with HCA’s existing ProviderOne Medicaid Management Information System (MMIS) hosted on AWS. The response must address architecture, security, scalability, reporting, implementation timeline, and pricing. • Build and/or host four required FHIR APIs (Patient Access, Provider Access, Payer‑to‑Payer, Prior Authorization) and extend the existing Patient Access API. • Provide a consent‑management framework (opt‑out/opt‑in) and a process to transform ~760 pages of policy guides into structured Da Vinci FHIR resources. • Integrate with HCA’s ProviderOne MMIS, Verato MPI, and Acentra Health’s existing infrastructure while meeting Washington State security and HIPAA requirements. • Deliver reporting/analytics, O&M support, and a clear implementation schedule to achieve full production by Jan 1 2028.