Payer-to-Payer Data Exchange

Payer-to-Payer Data Exchange

Payer-to-Payer Data Exchange

Is CMS still exercising enforcement discretion for the payer-to-payer data exchange provisions of the May 2020 Interoperability and Patient Access final rule (CMS-9115-F)?

On December 8, 2021, CMS announced its decision to exercise enforcement discretion to not take action on certain payer-to-payer data exchange provisions of the May 2020 Interoperability and Patient Access final rule (CMS-9115-F) until identified implementation challenges could be addressed in future rulemaking. The CMS Interoperability and Prior Authorization final rule (CMS-0057-F), released on January 17, 2024, addresses those challenges with its Payer-to-Payer API policies. For additional information on these policies, please refer to the final rule and fact sheet at https://www.cms.gov/priorities/key-initiatives/burden-reduction/policies-and-regulations/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f


Page Last Modified:
01/19/2024 01:12 PM