Monday, March 9, 2020

HHS and CMS issue final interoperability rules

PARCA eNews – March 9, 2020 –The US Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) today announced the final rules for implementing interoperability and patient access provisions of the 21st Century Cures Act.

Together the final rules mark the most extensive healthcare data sharing policies the federal government has implemented. The rules require both public and private institutions to share health information between patients and other parties in a private and secure manner.

“Delivering interoperability actually gives patients the ability to manage their healthcare the same way they manage their finances, travel and every other component of their lives," said Don Rucker, M.D., national coordinator for health information technology in a press release. "This requires using modern computing standards and APIs that give patients access to their health information and give them the ability to use the tools they want to shop for and coordinate their own care on their smartphones.”

Starting Jan. 1, 2021, Medicare Advantage, Medicaid, CHIP and other plans on the federal exchanges will be required to support a standardized API (HL7 FHIR) that will give patients access to claims and other cost information as well as medical information related to a clinical encounter.

In addition, the final rules call for a Provider Directory API among CMS-regulated payers that will allow patients to connect with a broad selection of provider options, or to help clinicians to contact other providers for care coordination.

The Office of National Coordinator also published additional resources about the final rules:

The ONC final rule
The CMS final rule
FAQ on the CMS final rule

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