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CMS Interoperability and Patient Access Final Rule

CMS recently introduced new interoperability mandates for health plans. This rule is designed to make health information more easily available between health systems by implementing new industry standards like FHIR APIs.

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CMS Interoperability and Patient Access Final Rule

The Centers for Medicare and Medicaid Services (CMS) is rapidly improving interoperability. Data that is siloed within disparate health systems is being unlocked to enable connectivity and collaboration between stakeholders, improving industry workflows and patient care.

The CMS Interoperability and Patient Access Final Rule covers policies that regulate a variety of stakeholders. The overall aim of this rule is to enable seamless interoperability throughout the healthcare system whilst giving patients access to their own health information. It also allows third-party app developers to leverage data to create apps that meet healthcare needs.

Policy & Compliance

The mandate includes the implementation of several upcoming policies:

Patient Access API

CMS-regulated health plans must enable patients to be able to access and share their health data through a FHIR-based API. 

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Deadline

July 1st, 2021

Provider Directory API

CMS-regulated health plans must create a FHIR-based Provider Directory API that is publicly available on their website.

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Deadline

July 1st, 2021

Payer to Payer API

CMS-regulated health plans must be able to share clinical data (USCDI v1) with other health plans upon a members request.

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Deadline

January 1st, 2022

X-Ray Results

Putting Patients First

All together, the Final Rule has the goal of breaking data barriers and reducing costs and burdens on both healthcare workers and organizations. This leads to better care, ultimately creating a future with improved patient health outcomes.

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