April 15, 2021
The Office of the National Coordinator for Health Information Technology (ONC) and the Center for Medicare and Medicaid Services (CMS) announced a rule to help drive interoperability and the exchange of patient data across healthcare systems. It requires
health plans to provide access to all patient clinical records in an electronic format within 24 hours of a request, regardless of provider affiliation. The goal is to give members timely access to their health data to better manage their own care.
The CMS interoperability rule beginning July 2021. This will impact our Medicare Advantage (MA) lines of business.
How will it work?
- Premera is creating a patient access application programming interface (API). API is a software connection that allows third-party apps to access member health data.
- Patient access API will be available to current Premera Medicare Advantage members.
- Patient access API gives members access to their claims, pharmacy, encounter, and clinical data dating back to 2016.
- Members can access through a third-party application, but only with their permission. Members decide if they want to use the service through an opt-in process.
- Members can choose a third-party app from their app store.
- Members also have access to a provider directory API.
- Current and former MA members will have access to the MA provider directory API. The MA directory will also be available to the public.
You can learn more about interoperability on the CMS website. As we get closer to launch, we’ll let you know where you can find resources and additional
information to help your patients.