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2020-12-18
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Medicaid Program; Patient Protection and Affordable Care Act; Reducing Provider and Patient Burden by Improving Prior Authorization Processes, and Promoting Patients' Electronic Access to Health Information for Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges; Health Information Technology Standards and Implementation Specifications
Part II
Proposed Rules
D09002ee1be6a4399
D09002ee1be6a44b8
United States
Department of Health and Human Services
originator
org
United States Government Agency or Subagency
United States
Centers for Medicare & Medicaid Services
originator
org
United States Government Agency or Subagency
United States
Office of the Secretary
originator
org
United States Government Agency or Subagency
This proposed rule would place new requirements on state Medicaid and CHIP fee-for-service (FFS) programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of health care data, and streamline processes related to prior authorization, while continuing CMS' drive toward interoperability, and reducing burden in the health care market. In addition, on behalf of the Department of Health and Human Service (HHS), the Office of the National Coordinator for Health Information Technology (ONC) is proposing the adoption of certain specified implementation guides (IGs) needed to support the proposed Application Programming Interface (API) policies included in this rule. Each of these elements plays a key role in reducing overall payer and provider burden and improving patient access to health information.
85 FR 82586
https://www.govinfo.gov/app/details/FR-2020-12-18/2020-27593
2020-27593
fr18de20-27
RIN 0938-AT99
4120-01-P
CMS-9123-P
https://www.govinfo.gov/app/details/FR-2020-12-18/2020-27593
https://www.govinfo.gov/content/pkg/FR-2020-12-18/html/2020-27593.htm
https://www.govinfo.gov/content/pkg/FR-2020-12-18/pdf/2020-27593.pdf
Grant Programs-Health
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Aid to Families with Dependent Children
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Administrative Practice and Procedure
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Intergovernmental Relations
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Organization and Functions (Government Agencies)
Prescription Drugs
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Technical Assistance
Women
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Computer Technology
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Incorporation by Reference
Laboratories
Medicare
Public Health
Security Measures
97 p.
82586
82682
85 FR 82586
Code of Federal Regulations
Title 42 Part 431
42 CFR Part 431
Code of Federal Regulations
Title 42 Part 435
42 CFR Part 435
Code of Federal Regulations
Title 42 Part 438
42 CFR Part 438
Code of Federal Regulations
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42 CFR Part 440
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42 CFR Part 457
Code of Federal Regulations
Title 45 Part 156
45 CFR Part 156
Code of Federal Regulations
Title 45 Part 170
45 CFR Part 170
Regulation Identification Number 0938-AT99
RIN 0938-AT99
Medicaid Program; Patient Protection and Affordable Care Act; Reducing Provider and Patient Burden by Improving Prior Authorization Processes, and Promoting Patients' Electronic Access to Health Information for Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges; Health Information Technology Standards and Implementation Specifications; Federal Register Vol. 85, Issue
PRORULE
2020-27593
II
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Office of the Secretary
2021-01-04
CMS-9123-P
4120-01-P
2020-27593
Proposed rule.
This proposed rule would place new requirements on state Medicaid and CHIP fee-for-service (FFS) programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of health care data, and streamline processes related to prior authorization, while continuing CMS' drive toward interoperability, and reducing burden in the health care market. In addition, on behalf of the Department of Health and Human Service (HHS), the Office of the National Coordinator for Health Information Technology (ONC) is proposing the adoption of certain specified implementation guides (IGs) needed to support the proposed Application Programming Interface (API) policies included in this rule. Each of these elements plays a key role in reducing overall payer and provider burden and improving patient access to health information.
To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on January 4, 2021.
Alexandra Mugge, (410) 786-4457, for general issues related to this rule and CMS interoperability initiatives.
Grant Programs-Health
Health Facilities
Medicaid
Privacy
Reporting and Recordkeeping Requirements
State Fair Hearings
Aid to Families with Dependent Children
Notices
Supplemental Security Income (Ssi)
Wages
Administrative Practice and Procedure
Health Insurance
Advertising
Brokers
Conflict of Interests
Consumer Protection
Grants Administration
Health Care
Health Maintenance Organizations (Hmo)
Health Records
Hospitals
Indians
Individuals with Disabilities
Intergovernmental Relations
Loan Programs-Health
Organization and Functions (Government Agencies)
Prescription Drugs
Public Assistance Programs
Technical Assistance
Women
Youth
Computer Technology
Health
Incorporation by Reference
Laboratories
Medicare
Public Health
Security Measures
Medicaid Program:
Patient Protection and Affordable Care Act; Reducing Provider and Patient Burden by Improving Prior Authorization Processes, etc.,
HealthCare.gov
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Vol. 85, no. 244
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2020-12-18
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Table of Contents:
AE 2.7:
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AE 2.106:
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https://www.govinfo.gov/app/details/FR-2020-12-18
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