CMS Rule

For an Integrated Delivery Network that is both a health plan and a care provider, do they need to make all the clinical data they maintain in both capacities available via API? 

The final rule defines ‘‘maintain’’ to mean the payer has access to the data, control over the data, and authority to make the data available through the API (85 FR 25538). We encourage each entity to look at how they maintain the data as part of the patient record to determine whether it fits within the criteria.

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