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Oregon is transforming health care delivery to improve health outcomes and quality of care while reducing costs for all Oregonians. Health information technology is essential to these efforts. Timely access to health information allows for improved communications, coordination and efficiencies across care settings. Health information technology supports patient-centered care, ensuring that the right health information is available to health systems, providers and patients at the right time and place.
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On December 10th, CMS released a proposed rule, building on the CMS Interoperability and Patient Access final rule (CMS-9115-F) that would require certain CMS-regulated payers to improve the electronic exchange of health care data via Application Program Interfaces (APIs) and streamline the prior authorization process to reduce burden on payers, providers, and patients. This proposed rule would place new requirements on Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs, and Qualified Health Plans (QHP) issuers on the Federally-facilitated Exchanges (FFEs).
For a summary of the proposed rule see the CMS Fact Sheet. The proposed rule can be found here: https://www.cms.gov/files/document/121020-reducing-provider-and-patient-burden-cms-9123-p.pdf. The comment period closes on January 4, 2021.
Highlights of the NPRM include that starting January 1, 2023 payers:
The NPRM also includes five Requests for Information (RFIs). CMS is seeking comments on the following:
Oregon community information exchanges (CIEs) are developing across the state, sponsored by Medicaid coordinated care organizations (CCOs), health plans and other organizations. CIE can be used by interested community-based organizations (CBOs), local public health authorities (LPHAs), and Tribes to coordinate wraparound and social services support for COVID-19 isolation and quarantine. Joining a CIE is voluntary and not required under the COVID-19 Grants for Community Based Organizations.
In coordination with internal and external partners, OHA has developed an informational flyer that provides further detail about CIE for COVID supports. We also plan to hold an informational webinar where community stakeholders interested in CIE can learn more, and to gather feedback in the future. We’ll share more information about these events in upcoming newsletters and on our OHA CIE website.
CIE is a network of healthcare and human/social service partners using a technology platform with functions such as a shared resource directory, “closed loop” referrals, reporting, social needs screening, and other features to electronically connect people to social services and supports.
Attendees are encouraged to submit questions they’d like to have answered. We’ll be accepting questions ahead of the webinar, until 5 pm Monday, November 2. You can submit your questions via the webinar registration or send an email directly to Marta Makarushka at Marta.M.Makarushka@dhsoha.state.or.us. The webinar will also include a Q&A period.
Register for the webinar > If you have questions about the webinar, please reach out to Marta Makarushka at Marta.M.Makarushka@dhsoha.state.or.us.
Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:
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