Highlights:

  • The U.S. Centers for Medicare and Medicaid Services issued a proposed rule Thursday aimed at improving the electronic exchange of healthcare data among payers, providers and patients. The rule would require Medicaid, CHIP and QHP programs to build HL7 FHIR-based APIs to support data exchange and prior authorization. It also includes a proposed API standard for healthcare operations nationwide.
  • The proposed rule seeks to enhance the patient access API by requiring the use of specific HL7 implementation guides by impacted payers. In addition, CMS is proposing that payers establish, implement and maintain a process ensuring that third-party app developers requesting to receive patient data will adhere to certain privacy provisions.
  • The rule also includes a proposal on behalf of the Office of the National Coordinator for Health IT to adopt the API implementation specifications for healthcare operations as part of a nationwide health IT infrastructure.

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