CMS Rule

Which parts of the final rule apply to my organization?

The Interoperability Rule has seven main components, some of which pertain to healthcare providers, others to
CMS-regulated payers, and one specifically to State Medicaid Agencies:

Providers

  • Provide Admission, Discharge, and Transfer (ADT) Event Notifications
  • CMS will publicly report providers:
    1) suspected of Information Blocking
    2) who do not maintain Digital Contact Information in the NPPES
All CMS-Regulated Payers
  • Implement a Patient
    Access API
  • Implement a Provider Directory API
  • Support Payer-to-Payer Data Exchange


State Medicaid Agencies Only
  • Increase the Frequency of Federal State Data Reporting Exchanges from Monthly to Daily



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