Who is impacted by the rules?  

These rules will impact all stakeholders within the health ecosystem, including the patients, providers, payers, health IT developers and vendors. Specific impacts to Payers and Providers:

  • Affected Payers will need to implement both a Patient Access API and a Provider Directory API; be able to facilitate data exchange between payers using data identified in United States Core Data for Interoperability (USCDI); expose claims data via FHIR and increase the frequency of data exchanges. 

  • Hospitals will need to comply with Admission, Discharge, and Transfer (ADT) event notifications mandate to meet the Conditions of Participation (CoPs) and care coordination requirements; while Providers must update their digital contact information and report promoting interoperability category data with a series of three information blocking criteria that may indicate a possibility of information blocking.