CMS Announces Pilot Program for Clinicians to View Claims Data of Medicare Beneficiaries

On July 30, 2019, the Centers for Medicare & Medicaid Services (CMS) announced “Data at the Point of Care” (DPC), a pilot program that will provide clinicians with access to claims data. The pilot program follows on the heels of the recently proposed Interoperability and Patient Access Proposed Rule, which would require regulated health plans to make patient data available through an application programming interface (API). These actions are also part of the MyHealthEData initiative spearheaded by the White House Office of American Innovation.

As part of the MyHealthEData initiative, last year CMS launched the Blue Button 2.0 API, which allows beneficiaries to access their health claims information electronically. The new DPC pilot program expands the use of Blue Button 2.0 to clinicians. As CMS explains, providing clinicians with health claims data is intended to “fill in information gaps for clinicians, giving them a more structured and complete patient history with information like previous diagnoses, past procedures, and medication lists.”

CMS has provided a link for clinicians interested in participating in the DPC pilot program:

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National Law Review, Volumess IX, Number 212