Patient Data Sharing in MA Proposed Rule
LeadingAge continues to advocate for improvements in the prior authorization processes used by Medicare Advantage (MA) plans, including shortening the time plans have to make those determinations. We also offered support to CMS proposals that would give providers access to patient data via an Application Programming Interface (API), allowing the plan data source to talk to the provider’s EHR.
LeadingAge argued that CMS should allow all providers who serve a plan’s enrollee to access this data not just those who contract with the plan as an in-network provider. This proposed rule also covers a framework for establishing a Patient API and a Payer-to-Payer API to share patient data. Many of the proposals for data sharing apply to both Medicare and Medicaid FFS as well as Medicare Advantage and Medicaid managed care.
CMS to Surveyors: Curb Hospice Fraud