After completing the Patient Access and Provider Directory API rules, you must now begin preparing for the next major requirement of the CMS Interoperability mandate - the Payer-to-Payer Data Exchange - which comes into effect on January 1, 2022.
By January 2022, regulated payers must be able to electronically exchange certain data elements finalized in the ONC Cures Act Final Rule, such as patient clinical data from the U.S. Core Data for Interoperability version 1 data set, upon a current or former enrollee’s request. While payers are required to share data received from another payer under this requirement in the electronic format they were received, FHIR API’s will be an important method to comply with this rule.
While technical interoperability deployment attention shifts to a business-to-business exchange of data, the intent of the rule remains firmly focused on empowering patients to control and access their health data at their discretion.
The data received from a previous payer will be presented back to a new enrollee’s request through the Patient Access API, and for those leaving your plan, you must provide this data to the new plan provider within the timeframe required by the rule. The transactions associated with payer-to-payer data exchange will be unlike others that plans have been accustomed to, whereby –
In this second webinar series, we will identify and discuss the key planning requirements that are involved and how to address them quickly and cost effectively in alignment with the continued evolution of HL7 FHIR-based interoperable healthcare standards. Key topics that will be discussed are:
Join the webinar to succeed in your interoperability journey and be future ready!
Chief Interoperability Officer
& CMS Blue Button Innovator
Senior Director – Business Consulting,