CAQH has announced the development of a centralized directory of validated payer FHIR endpoints and third-party applications. This solution will simplify how healthcare organizations and app developers connect with each other to help consumers access and transfer their healthcare information. The directory, developed with support from the technology company Edifecs, will help payers meet new Centers for Medicare and Medicaid Services (CMS) interoperability regulations that become effective in 2021 and 2022.

Earlier this year, CMS released a final Interoperability and Patient Access rule that requires CMS-regulated plans to enable consumers to access their healthcare information on a third-party app of their choice. Under the rule, consumers must also be able to transfer that information from a previous health plan to their current plan. The CMS rule requires the use of Fast Healthcare Interoperability Resource (FHIR) application programming interfaces (APIs) to share this information between plans and apps. The CMS rule is intended to facilitate better decision-making, care coordination and improved health outcomes. 

The Office of the National Coordinator for Health Information Technology (ONC) FHIR at Scale Task Force (FAST) has highlighted the need for an endpoint directory as part of an overarching set of proposed solutions to advance FHIR implementation at scale.

A prototype of the CAQH Endpoint Directory that builds on the ONC FAST foundation was presented at a recent HL7 FHIR Connectathon to gather industry input and test certain portions of functionality. The feedback affirmed that development of the CAQH Endpoint Directory meets an industry need and can play a helpful role in supporting compliance with the CMS rule. Over the coming months, CAQH will continue to engage industry implementers and experts to launch the solution early in 2021 in time to enable plans to meet CMS requirements.

To learn more about the CAQH Endpoint Directory, click here, or register to receive email updates.

To read the press release, click here.