CMS Interoperability and Patient Access Final Rule
The Interoperability and Patient Access final rule (CMS-9115-F) put patients first by giving them access to their health information when they need it most, and in a way they can best use it. This final rule focused on driving interoperability and patient access to health information by liberating patient data using CMS authority to regulate Medicare Advantage (MA), Medicaid, Children's Health Insurance Program (CHIP), and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs).
Recognizing the challenges faced by payers during the COVID-19 public health emergency, CMS exercised enforcement discretion for the Patient Access API and Provider Directory API policies for MA, Medicaid, CHIP and QHP issuers on the FFEs* effective January 1, 2021 through July 1, 2021. CMS began enforcing these new requirements on July 1, 2021.