{"id":21483,"date":"2020-12-18T17:39:03","date_gmt":"2020-12-18T12:09:03","guid":{"rendered":"https:\/\/mobisoftinfotech.com\/resources\/?p=21483"},"modified":"2025-12-23T16:11:34","modified_gmt":"2025-12-23T10:41:34","slug":"cms-interoperability-and-patient-access-final-rule","status":"publish","type":"post","link":"https:\/\/mobisoftinfotech.com\/resources\/blog\/cms-interoperability-and-patient-access-final-rule","title":{"rendered":"CMS Interoperability and Patient Access Final Rule"},"content":{"rendered":"

The current COVID-19 pandemic has shaken the healthcare organizations at an enormous level. Healthcare practitioners and other providers have been the frontline warriors amidst this unprecedented circumstance and experiencing the maximum pressure of treating their patients. CMS compliance requirements and deadlines have been creating a wave of uncertainty and pose a challenge for patients and health organizations when it comes to secure healthcare data exchange. Changing technology, complex data sets, and new use cases to enable Patient Access, Provider Directory, and Payer-to-Payer Data Exchange functionality have all become vital from being \u201crequired\u201d rather than being \u201cnecessary\u201d.<\/span> <\/p>\n\n\n\n

Today, most healthcare organizations have data in electronic health records (EHRs). Pharmaceutical companies are also developing pathways to include patient experience back into their research and findings as a part of their standard processes. API adoption, use of cloud, dedicated resources, skilled staff are all essential when it comes to preparing for broader data exchange. <\/p>\n\n\n\n

How CMS Can Help Overcome Interoperability Challenges?<\/b><\/h2>\n\n\n\n

As per a report from Deloitte, \u201cIn January 2019, HL7 released the fourth version of FHIR. This standard method of exchanging health information electronically focuses more on breaking down data into modular components and is designed specifically for web environments. Thus, it can work for mobile phone applications, cloud, and EHR data\u201d. <\/p>\n\n\n\n

As governments announced the strict home-quarantine and social distancing protocols, the chronically ill and elderly members faced the challenge of not receiving proper care, which led to further health deterioration. Medicare beneficiaries are turning to Medicare Advantage plans to help cover the gaps with the CMS interoperability and patient access final rule. Most importantly, members were unable to receive the proper information regarding the development of their health including having a seamless member experience due to fragmented communication systems. For healthcare organizations, security on information and private data is also another challenge, as cybercrime is gaining momentum. Implementing FHIR-based Interoperability Gateway Enhancing Overall Data Exchange Flowing Across Systems and Stakeholders can help everyone in the healthcare ecosystem<\/a>.<\/p>\n\n\n\n

The Centre for Medicare and Medicaid Services<\/a> first launched the interoperability and patient access rule on the 9th of March, 2020 but had to push the launch date to January 2021. As payers require time to put forth the data from January 2016 on their system. The technological changes in the healthcare system have been inevitable. The interoperability and patient access rule put forth by CMS are primarily focused on serving the patients first. Here are the key elements with the timeline: <\/p>\n\n\n\n