Change Healthcare Offers Free API Solution for Health Plans to Meet CMS Deadline

May 13, 2020

Change Healthcare has announced it will be making its application programming interfaces (APIs) available for free to help health plans quickly comply with the government’s recent interoperability and patient access final rule.

Per the Centers for Medicare & Medicaid Services’ (CMS) final rule released in early March, starting in 2021, health plans in Medicare Advantage, Medicaid, CHIP, and through the federal exchanges will be mandated to share claims data electronically with patients “in a safe, secure, understandable, user-friendly electronic format through” industry standard APIs.

What’s more, as Change Healthcare officials have pointed out, “Health plans must mitigate significant cybersecurity and consent risks, as patient data can only be made available to third parties authorized by the patient.”

They say that the company’s Connected Consumer Health interoperability solution “reduces the cost, complexity, and deployment barriers to empower payers to rapidly meet CMS’ regulatory requirements. In addition to standards-based interoperability APIs, the solution includes the necessary security, identity management, and consent management capabilities to enable health plans to administer patient identity and to provide data to third-party applications in accordance with CMS regulations and HIPAA.”

They further noted that health plans should begin by assessing their data readiness and develop a plan to meet the CMS deadlines. “This is a time-sensitive, complex, and potentially costly issue, with many challenges that payers are seeking to address now,” said Kris Joshi, Ph.D., president, Network Solutions, at Change Healthcare.

Due to the COVID-19 pandemic, federal health officials recently announced that they will be providing some relief to stakeholders complying with their final interoperability regulations. Related to the CMS API requirement, Administrator Seema Verma noted the agency “will exercise enforcement discretion for a period of six months in connection with these two API provisions. Therefore, as a result of COVID-19, and to provide additional flexibility to payers, CMS will not enforce the new requirements…until July 1, 2021.”

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