Review of Proposed Rule to Promote Interoperability in Federal Health Care Programs

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April 2019

On March 4, 2019, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to advance interoperability among health care data systems and improve patient access to health care records. The rule affects state Medicaid and CHIP fee-for-service programs, Medicaid and CHIP managed care organizations, and providers that participate in Medicaid and CHIP, as well as parts of the Medicare and federally facilitated exchange programs.

As proposed, the rule would allow patients to have access to information currently held in different IT systems by requiring Medicaid and CHIP health plans to exchange electronic patient data with other plans. It would also require state agencies and health plans to make patient-level data available for use in third party applications. The proposed rule would also require states to exchange data on individuals dually eligible for Medicaid and Medicare on a daily—instead of a monthly—basis. The slide presentation includes a summary of the provisions of the proposed rule, as well as potential issues on which the Commission may want to comment.

Publication Type: Presentations

From: April 2019 MACPAC Public Meeting

Tags: administrative capacity, data, information technology