Information on New CMS Regulations


The Centers for Medicare and Medicaid Services (CMS) have issued a new rule titled Final Rule (CMS 9115-F). The CMS Final Rule was finalized as a regulation in May 2020. What is this rule and how will it change the way your practice handles business?

Under the new CMS Final Rule (CMS 9115-F) Provider and Payers are required to share data with patients to improve access to data and coordinate care.  Much like the Medicare Blue Button initiative, which allows Medicare beneficiaries access to their data via applications and services, the CMS Final Rule is designed to allow beneficiaries access to their data at providers and payers, including Medicaid, CHIP Plans, and Medicare Advantage Plans.

Access to this data will require authorization and authentication by providers and payers and will impact the HIPAA policies and procedures for providers and payers as patients request their data.  HIPAAtrek has been closely following the CMS Final Rule, the ONC Final Rule, and newly proposed CMS Final Rule #2 for Prior Authorization.  Many things are changing, including allowing patients to have access to their data, much like under the Medicare Blue Button initiative, due to this CMS Final Rule and other proposed Final Rules.

The HL7 Fast Healthcare Interoperability Resources (FHIR) standard has also been adopted by CMS as a standard and a requirement for providers and payers to use to share patient information.  We will share more about FHIR in our upcoming blog posts!

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