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On December 11, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule designed to improve electronic health care data exchange and streamline the prior authorization process. The CMS fact sheet accompanying the proposed rule stated that its goal is “reducing overall payer and provider burden and improving patient access to health information.”
The proposed rule includes five sets of proposals and five requests for information. The proposals include the following:
Patient Access Application Programming Interface (API) – This proposal builds on the Interoperability and Patient Access final rule, which required certain payers to implement a Fast Healthcare Interoperability Resources-based Patient Access API. CMS would now require these payers to include information about patients’ pending and active prior authorization decisions in the API. These payers would also be required to maintain
By GCN Staff
Dec 15, 2020
To help manage the U.S. COVID-19 vaccination program, the Centers for Disease Control and Prevention is using cloud infrastructure and health management applications from Oracle.
The Oracle National Electronic Health Records Cloud will serve as the CDC s central data repository for all vaccination data in the nation, the company announced, receiving data from all U.S. jurisdictions administering vaccinations.
Oracle also developed a suite of public health management applications to help public health agencies and health care providers collect and analyze data related to COVID-19. The Oracle National EHR Database and Public Health Management Applications were first used in June to register and directly communicate with over 500,000 people who volunteered to participate in clinical trials for COVID-19 vaccines and therapeutics.
How APIs are aiding the healthcare industry in the 21st century
Without a doubt, the pandemic has accelerated digital transformation initiatives, and, in our new remote working environment, enterprises are focusing on how they can continue to provide seamless digital experiences to consumers. To achieve this, APIs are widely recognized as the oil that fuels our digital world, and different types of APIs power the digital mesh to which we are now all connected.
Once considered niche, API technology has now become mainstream and is viewed as an integral part of the day-to-day digital landscape. In fact, according to The Forrester Wave: API Management Solutions, Q3 2020 report, By opening access to digital business capabilities, APIs drive agility to optimise customer experiences, create dynamic digital ecosystems, achieve operational excellence, and build platform business models.
HHS wants to boost interoperability for Medicaid and CHIP
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HHS wants to make it easier for beneficiaries covered by Medicaid, the Children s Health Insurance Program or individual market plans to access and share their health information and speed up prior authorization for such plans, according to a proposed rule on Monday.
The proposal would require covered payers to follow specific implementation guidelines for application programming interfaces that increase access to patient health information and provider directories. It would also mandate that impacted payers force third-party app developers to agree to specific privacy requirements to access patient data and notify CMS about patient data requests every quarter. The proposal would apply to state Medicaid and CHIP fee-for-service programs, Medicaid managed care plans, CHIP managed care entities and qualified health plans available through federal marketplaces.
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This week in Washington: Congress passes funding bill for an additional week to come up with full-year spending legislation to avoid a government shutdown.
Administration
FDA Announces It Will Quickly Authorize Pfizer Vaccine
CMS Releases Information on the Best Practices for Designing and Implementing Substance Use Disorder (SUD)-Focused Health Homes
Proposed Rules
CMS Proposes New Rules to Address Prior Authorization
Final Regulations/Guidance
Courts
Reports
GAO: Medicaid - CMS Needs More Information on States’ Financing and Payment Arrangements to Improve Oversight
Administration
Trump Signs One-Week CR Spending Bill