CMS Begins Enforcement of Interoperability and Patient Access Rule

July 2021

Delayed several months for pandemic-related reasons, July 1st marks the beginning of enforcement by CMS of the CMS Interoperability and Patient Access Rule. In conjunction with the 2016 Cures Act, the CMS Interoperability and Patient Access Rule aims to bolster access by patients and providers to health records and other care-related data. Increased interoperability is to come through regulation of payers: Medicare Advantage organizations, Medicaid fee-for-service and managed care plans, CHIP programs, and more. Improved application programming interfaces will allow for data transparency that is secure to both satisfy patient protection requirements and promote seamless access to health records – two rights under HIPAA. Many key stakeholders have room to benefit from this policy, though CMS is hopeful that it will directly affect the patient-provider relationship and the delivery of high-quality care.

Enforcement of the CMS Interoperability and Patient Access Rule has initiated a new opportunity for improved health outcomes. Access to health data will enable patient participation in care decisions and will likewise allow providers to curate coordinated and precise care plans. Other implications of increased interoperability promote the investigation of healthcare-related inefficiencies and the development of evidence-backed solutions by stakeholders. CMS monitoring of the balance between access and privacy protections will persist as this new rule begins to impact health systems and drive quality care.

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