LeadingAge continued to advocate for improvements in the prior authorization processes used by MA plans including shortening the time plans have to make those determinations. In addition, LeadingAge offered its support to CMS proposals that would give providers access to patient data via an Application Programming Interface (API), which would allow the plan data source to talk to the provider’s EHR. LeadingAge argued that CMS should allow all providers who serve a plan’s enrollee to access this data not just those who contract with the plan as an in-network provider. This proposed rule also covers a framework for establishing a Patient API and a Payer-to-Payer API to share patient data. Many of the proposals for data sharing apply to both Medicare and Medicaid FFS as well as Medicare Advantage and Medicaid managed care. To view the full comment letter on this proposed rule, click here.
