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  • 21st Century Cures Act and the CMS Patient Access API

  • For Developers

    The 21st Century Cures Act, signed as law on December 13, 2016, aims to “accelerate the discovery, development, and delivery of 21st Century cures,” including providing patients access to their electronic health information that is "easy to understand, secure and updated automatically."

    To help meet this goal, the Centers for Medicare & Medicaid Services (CMS) created the CMS Interoperability and Patient Access rule (CMS-9115-F). In order to increase patients' access to their health data, the CMS rule prohibits information blocking and requires health insurance plans to give members access to their records and the ability to share their health plan data via an API endpoint with third-party applications of their choice.

    CMS have given health plans until July 1st, 2021 to comply with this mandate. Affinity Health Plan utilizes 1upHealth APIs to create applications that interact with electronic health data including clinical and claims data via the CMS approved FHIR standard.

    For Members

    The Centers for Medicare & Medicaid Services (CMS) created the CMS Interoperability and Patient Access rule (CMS-9115-F) to increase patients' access to their health data, prohibit information blocking and require health insurance plans to give members access to their records in order to share their health data with third-party applications of their choice. Affinity Health Plan has contracted with 1upHealth, an industry leader in healthcare data integrations, to give you access and the ability to share your information. When you wish to add your healthcare data to third-party applications, such as MyCharts, Apple Health, or FitBit. Once your identity is confirmed, Affinity will share your healthcare data with the third-party application you have chosen.

    There are a host of benefits to this new ability to access and share your data. Some apps allow you to combine your data from multiple health systems to create a complete record of your interactions with different doctors and hospitals, and even combine it with data you generate on your own from wearable devices like glucose meters, pedometers, or heart rate monitors. Some other common uses include prescription drug management, chronic disease management, nutrition tracking, and care coordination. Data sharing empowers you to have greater ownership of and visibility into your health information, and has the potential to improve both your health and the quality of care you receive from the health care system.

    As with any interaction over the internet, there are some risks. However, Affinity Health Plan takes your privacy and the security of your health information as seriously as you do. That's why your data will never be shared without your express permission. Your health plan safeguards your data throughout the process of sharing it in several ways, including using challenge questions and multi-factor authentication to confirm you - and no one else - can access and share your data. It is important to understand though, that once your data is shared with a third-party application, Affinity Health Plan is no longer responsible for the security of that data. This is why it is important to read the privacy and security policies for any application you choose to share your data with, to make sure you understand how it is protected and used by that application.