This is a FHIR testing system
- May 2025
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touchstone.aegis.net touchstone.aegis.net
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This is the source of the JSON files at the payer websites that show the plan data for each healthcare.gov available plan which is an "Exchange Qualified Health Plan" or QHP for short
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www.law.cornell.edu www.law.cornell.edu
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§ 170.213 United States Core Data for Interoperability. The Secretary adopts the following versions of the United States Core Data for Interoperability standard: (a) Standard. United States Core Data for Interoperability (USCDI), July 2020 Errata, Version 1 (v1) (incorporated by reference, see § 170.299). The adoption of this standard expires on January 1, 2026. (b) Standard. United States Core Data for Interoperability Version 3 (USCDI v3) (incorporated by reference, see § 170.299). [89 FR 1428, Jan. 9, 2024]
This page seems to indicate that many of the standards have a refernce back to USCDI both v1 and v3, with v1 expiring at the beginning of 2026.
Does this mean that USCDI is not mandating NPI until 2026.
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www.law.cornell.edu www.law.cornell.edu
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This page documents the various FHIR standards that are generally encorporated into other API standards.
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Annotators
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www.law.cornell.edu www.law.cornell.edu
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must implement and maintain a standards-based Application Programming Interface (API)
Here it says that the MA plans must be "standards-based".
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without special effort
This is the simple phrase that means it must be standards compliant.
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This is the requirements for Medicare Advantage Payers to implement directories that explain coverage contents.
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www.cms.gov www.cms.gov
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In the Interoperability and Patient Access final rule (CMS-9115-F), CMS encouraged MA-PD plans to build a Provider Directory API that is conformant to the Health Level Seven International® (HL7®) PDex Plan-Net Implementation Guide (85 FR 25529).
Apparently PDex standard is "encouraged." but not required.
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georgewbush-whitehouse.archives.gov georgewbush-whitehouse.archives.gov
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Transforming Health Care: The President’s Health Information Technology Plan
President GW Bush health information technology plan, which included the creation of the Office of the National Coordinator ONC. Released shortly after his state of the union a few months earlier.
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When arriving at a physician’s office, new patients do not have to enter their personal information, allergies, medications, or medical history, since it is already available.
Specific interoperability goal outlined by president Bush
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web.archive.org web.archive.org
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to make medical records easier to see for those who should see them, and much harder to see for those who shouldn't.
Bill Clinton discussing in simple terms the portions of HIPAA designed to ensure the medical records would be interoperable in a secure fashion.
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www.congress.gov www.congress.gov
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has published application programming inter-faces and allows health information from such tech-nology to be accessed, exchanged, and used withoutspecial effort through the use of application program-ming interfaces or successor technology or standards,as provided for under applicable law, including pro-viding access to all data elements of a patient’s elec-tronic health record to the extent permissible underapplicable privacy laws
This is the section of the CURES act that specifically mandates API based interoperability.
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enables the secure exchange of electronic healthinformation with, and use of electronic health informationfrom, other health information technology without specialeffort on the part of the user
This is the second clause in the CURES act that mandates general standards-based health information exchange using the "without special effort" clause
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pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov
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without special effort.
Ken Mandls JAMIA article highlying the CURES ACT rules on interop
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