HHS' interoperability rule, issued last year by CMS and finalized March 9, will require Medicare and Medicaid plans to adopt standard application programming interfaces that will help patients access their electronic health data more easily.
With the APIs, Medicare and Medicaid beneficiaries will be able to use third-party apps to store their electronic health information such as insurance claims and benefit information. The rule, which was released in conjunction with ONC's interoperability rule, will require healthcare providers and health IT vendors to implement the API requirements within two years of the publication of the final rules.
Here are seven dates to know regarding HHS' final interoperability rules and when the new policies will go into effect:
Late 2020: CMS will begin publicly reporting eligible clinicians, hospitals and critical access hospitals that may be information blocking based on how they documented certain Promoting Interoperability Program requirements. CMS will start with data collected for the 2019 performance year.
Late 2020: CMS will begin publicly reporting providers who do not list or update their digital contact information, including information in the National Plan and Provider Enumeration System.
Jan. 1, 2021: CMS-regulated payers are required to implement and maintain an HL7 Fast Healthcare Interoperability Resources standard API, referred to as the Patient Access API, which allows patients to easily access their claims and encounter information via third-party apps of their choice.
Jan. 1, 2021: Medicare Advantage organizations, Medicaid and CHIP fee-for-service programs, Medicaid managed care plans, and CHIP managed care entities must implement the Provider Directory API. This standards-based API will make provider directory information publicly available.
Jan. 21, 2021: CMS' interoperability and patient access final rule will require Medicare Advantage, Medicaid, CHIP and federal exchanges health plans to begin electronically sharing claims data with patients.
Jan. 1, 2022: CMS-regulated payers are required to implement a process for exchanging patient clinical data at the individual's request, so patients can take their information with them as they move from payer to payer over time.
April 1, 2022: CMS will start requiring states to send enrollee data for beneficiaries enrolled in both Medicare and Medicaid from monthly to daily exchange.