HealthApril 05, 2021

Interoperability and patient access final rule: What payers need to know

With the announcement on March 9, 2020, of the Interoperability and Patient Access Final Rule, the Centers for Medicare & Medicaid Services has set a timeline with significant implications for healthcare payers.

Specifically, the final rule impacts plans providing coverage to beneficiaries of Medicare Advantage (MA), Medicaid, Children’s Health Insurance Program (CHIP), and Qualified Health Plans (QHPs) available through the health insurance exchanges across the United States.

To meet these new interoperability and patient access requirements, payers need to develop a strategy to meet these new requirements for data access and sharing based on the deadlines established by CMS.

Download this interoperability and patient access executive summary to learn:

  • What is required by payers to satisfy the Patent Access API and Provider Directory API
  • What is required regarding the patient's request to exchange clinical data between payers and the new USCDI data set
  • The privacy and security implications of information sharing

By taking proactive steps payers can design and execute an implementation plan that not only satisfies the requirements of the Interoperability and Patient Access Final Rule but also moves the industry closer to the goal of putting patients truly at the center.

Complete the form to download the whitepaper
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