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Office of Health Information Technology

Better information to improve patient health

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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Latest News

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:

  • Add prior authorization decisions to Patient Access API information sharing requirements
  • Implement a privacy policy attestation process for third-party app developers
  • Implement a Provider Access API for payer-to-provider data sharing
  • Reduce prior authorization burden on providers through the implementation of APIs and other requirements
  • Meet additional Payer-to-Payer requirements, including the use of a FHIR-based API similar to Patient Access
  • Add claims, encounters, and prior authorization decisions to Payer-to-Payer Exchange information sharing requirements
  • Adopt specified implementation guides to support API implementation

The NPRM also includes five Requests for Information (RFIs). CMS is seeking comments on the following:

  • Methods for Enabling Patients and Providers to Control Sharing of Health Information
  • Electronic Exchange of Behavioral Health Information
  • Reducing Burden and Improving Electronic Information Exchange of Documentation and Prior Authorization
  • Reducing the Use of Fax Machines for Health Care Data Exchange
  • Accelerating the Adoption of Standards Related to Social Risk Data​


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.

Flyer:


About CIE

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.

Learn more about CIE in Oregon
Federal Interoperability Final Rules Webinar for CCOs/Payers

We’re pleased to announce that OHA’s Office of Health IT is hosting a Federal Interope​rability Final Rules ​Webinar, specifically tailored to CCOs/payers (including Medicare Advantage plans). The webinar will take place on November 5, 2020, from 2 – 4 pm. The ONC and CMS final rules implement interoperability and patient access provisions of the 21st Century Cures Act, requiring the implementation of new policies that will give patients unprecedented safe, secure access to their health data. National health IT subject matter expert, Rim Cothren, will present on the CMS Interoperability and Patient Access final rule payer requirements. In addition, representatives from the Oregon Health Authority who cover Medicaid Coordinated Care Organizations (CCOs), Dental Care Organizations (DCOs), and Fee-For-Service will be present to provide information and answer questions.

The webinar will:
  1. Review CMS Interoperability and Patient Access final rule requirements for applicable CMS-regulated payers
  2. Share what OHA is doing in relation to the rules
  3. Discuss what CCOs/payers need to do
  4. Highlight impact to health plan member experience
  5. Explore opportunities for coordination among impacted payers and sharing of best practices
  6. Answer questions
Who should attend? Anyone can attend. This free webinar is intended to orient CCOs/payers (including Medicare Advantage plans) to the CMS Interoperability and Patient Access final rule payer requirements and what OHA is doing.

Send in your questions!

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:

  • Sign language and spoken language interpreters
  • Written materials in other languages
  • Braille
  • Large print
  • Audio and other formats 
If you need help or have questions, please contact Marta Makarushka at (971) 239-9541 or Marta.M.Makarushka@dhsoha.state.or.us at least 48 hours before the meeting. OHA will make every effort to provide services for requests made closer to the meeting.​

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