Compliance dates
Dates that bind, drawn from final rules, certification program requirements, and exchange framework SOPs. The regulatory tracker covers what is open for comment and what has just been published; this page covers what you have to be ready for.
Next 90 days
The action window. Anything here needs a decision now.
2026-10-28
in 12 days
Updates to the Master List of Items Potentially Subject to Face-to-Face Encounter and Written Order Prior to Delivery take effect.
Binds DMEPOS suppliers, ordering clinicians · Federal Register 2026-15446 · source checked 2026-08-02
Firm
2026-12-31
in 76 days
ONC updates SVAP test data and tools for the 2026 approved standards: the Cypress Testing Tool, the Edge Test Tool, C-CDA validators, and the Inferno g.10 Standardized API Test Kit.
Binds ONC · ONC 2026 Approved SVAP Standards · source checked 2026-10-05
This is ONC's own delivery commitment, not an obligation on developers. It matters because a developer cannot certify to the 2026 SVAP versions until the tooling lands, so it gates everyone else's timeline.
Firm
2027-01-01
in 77 days
Impacted payers must operate four FHIR APIs: Patient Access with prior authorization data, Provider Access, Payer-to-Payer, and Prior Authorization.
Binds Medicare Advantage, Medicaid and CHIP FFS, Medicaid and CHIP managed care, QHPs on the FFEs · CMS-0057-F final rule, 89 FR 8758 · source checked 2026-10-05
The largest health IT compliance date on the horizon, and it is not a flat date. MA organizations and state Medicaid and CHIP FFS must comply by January 1, 2027; Medicaid and CHIP managed care comply beginning with the first rating period on or after that date; QHPs on the FFEs by the first plan year beginning on or after it. Practices will feel this through payer workflow changes, not through their own obligations.
Firm
2027 and beyond
The long arc, where standards and certification timelines live.
2027-07-01
in 258 days
Insights Condition reporting opens, but under enforcement discretion ONC expects reporting on only one of the seven measures: use of FHIR in apps through certified health IT.
Binds certified health IT developers · ONC HTI-1 final rule and Enforcement Discretion Notice dated April 29, 2025 · source checked 2026-10-05
The rule text still says first reporting July 2027 phasing to all measures by July 2029. The operative position is narrower: ONC will not exercise direct review for non-compliance with 45 CFR 170.407(b) except the FHIR-in-apps measure at 170.407(a)(3)(iv), with (A) and (B) due July 2027 and (C) July 2028. The discretion runs until HHS completes a deregulatory action to remove or revise 170.407 and 170.523(u), so treat the full seven-measure timeline as unlikely to arrive as written.
Enforcement discretion
2027-07-01
in 258 days
All TEFCA IAS FHIR endpoints deployed for Response Mode 1 must support the HL7 scalable registration, authentication, and authorization security requirements.
Binds QHINs, IAS Providers · TEFCA RCE, IAS Exchange Purpose Implementation SOP v3.0 · source checked 2026-10-05
Firm
2027-12-31
in 441 days
Decision Support Interventions criterion 170.315(b)(11) privacy and security updates due.
Binds certified health IT developers · ONC HTI-2 final rule · source checked 2026-10-05
Previously attributed on this page to HTI-1. ONC's own criteria-by-deadline table lists it as an HTI-2 update. The DSI criterion is the closest thing to an AI transparency requirement in certification, so watch any deregulatory action touching it.
Firm
2027-12-31
in 441 days
Electronic prescribing criterion 170.315(b)(3) must be updated to the newer NCPDP SCRIPT standard. The transition period allowing either SCRIPT 2017071 or 2023011 ends.
Binds certified health IT developers · ONC HTI-4 final rule, effective October 1, 2025 · source checked 2026-10-05
Firm
2028-01-01
in 442 days
Health IT Modules certified to the 170.315(b)(3) electronic prescribing criterion must also complete certification to the 170.315(b)(4) real-time prescription benefit criterion.
Binds certified health IT developers · ONC HTI-4 final rule · source checked 2026-10-05
A certification dependency rather than a standalone deadline. A developer that holds (b)(3) and does nothing loses it.
Firm
2028-01-01
in 442 days
Currently adopted versions of the health IT standards in 45 CFR 170.215(j)(1) through (3), (k)(1), (m), and (n) expire, leaving only the newer versions adopted in the FY2027 IPPS rule.
Binds certified health IT developers, ONC-ACBs · CMS and ONC FY2027 IPPS final rule, FR 2026-15833 · source checked 2026-08-02
A version cliff, not a new requirement. These standards underpin the electronic prior authorization certification criteria, so developers who have not moved by this date lose the older path.
Firm
2028-01-01
in 442 days
VTE-1, VTE-2, and STK-02 eCQMs removed from the Medicare Promoting Interoperability Program, beginning with the CY2028 reporting period.
Binds hospitals, critical access hospitals · CMS FY2027 IPPS final rule, FR 2026-15833 · source checked 2026-08-02
Reporting-period change rather than a hard date. Hospitals should confirm their vendor's eCQM configuration ahead of the CY2028 period.
Firm
Already in effect (7)
Kept for reference.
2026-10-01
FY2027 Medicare payment rules took effect: SNF PPS, IRF PPS, IPF PPS, and Hospice wage index, each carrying quality reporting and interoperability provisions.
Binds hospitals, post-acute providers · Federal Register, FY2027 final rules · source checked 2026-08-02
Effective dates pulled from structured Federal Register fields. Individual rules are itemised on the tracker.
In effect
2026-10-01
FY2027 IPPS and LTCH PPS final rule took effect, including ONC's adoption of updated health IT standards in 45 CFR 170.215 on behalf of HHS.
Binds acute care hospitals, long-term care hospitals, health IT developers · CMS and ONC joint final rule, FR 2026-15833 · source checked 2026-08-02
A joint CMS and ONC rule, which is why health IT standards ride along in a payment rule. The adopted standards are referenced in ONC certification criteria for electronic prior authorization and in CMS-0057-F.
In effect
2026-08-29
2026 SVAP approved standards became available for voluntary use in certified Health IT Modules: USCDI v6, HL7 FHIR US Core IG STU 9.0.0, and C-CDA Release 5.0.0.
Binds health IT developers · ONC 2026 Approved SVAP Standards, announced June 30, 2026 · source checked 2026-10-05
Voluntary, not a mandate. SVAP lets a developer certify to a newer standard version ahead of any rulemaking requiring it.
In effect
2026-08-03
TEFCA Individual Access Services Exchange Purpose Implementation SOP v3.0 took effect, including NIST IAL2 identity verification for individuals before first use of TEFCA Exchange.
Binds QHINs, IAS Providers, TEFCA participants · TEFCA RCE, IAS Exchange Purpose Implementation SOP v3.0 · source checked 2026-10-05
In effect
2026-03-01
ONC enforcement discretion ended for the HTI-1 certification criteria updates originally due January 1, 2026, covering fifteen criteria including transitions of care, care plan, and the standardized API for patient and population services.
Binds certified health IT developers, ONC-ACBs · ONC Enforcement Discretion Notice EDN2025.06, dated November 24, 2025 · source checked 2026-10-05
Issued after the October 1 to November 12, 2025 lapse in appropriations cut off access to testing tools. Developers effectively had through February 28, 2026 to complete the updates.
In effect
2026-01-01
TEFCA data created or captured and sent must conform to USCDI v3 data classes, elements, and vocabulary.
Binds QHINs, TEFCA participants · ONC TEFCA program requirements · source checked 2026-10-05
An earlier version of this entry also claimed a QHIN HL7 FAST security requirement on the same date. That could not be confirmed in the primary TEFCA documents and has been removed rather than left standing.
In effect
2026-01-01
CMS-0057-F operational prior authorization provisions took effect, including shortened decision timeframes and public reporting of prior authorization metrics.
Binds Medicare Advantage, Medicaid and CHIP FFS and managed care, QHPs on the FFEs · CMS-0057-F final rule, 89 FR 8758 · source checked 2026-10-05
The operational half of CMS-0057-F. The API half is the January 2027 date below.
In effect
Curated, not automated. Source data last updated 2026-10-05. Staged compliance dates appear in rule preambles and program SOPs as prose, not in any structured field, so this page is maintained by hand. Every entry links to the primary document the date is stated in, and carries the date that link was last checked. Entries that cannot meet that bar are left off rather than published with a caveat.