…of Health Level 7® (HL7) Fast Healthcare Interoperability Resources® (FHIR) for APIs 2. Privacy and Security Concerns in the Context of APIs 3. Specific Technical Approach and Standards B. Content and Vocabulary Standards C. Application Programming Interface (API) Standard D. Upd…

…-Time Prescription Benefit Criterion (d) New Certification Criteria for Modular API Capabilities (e) New Certification Criteria for Electronic Prior Authorization 3. Summary of Costs and Benefits B. Background Summary 1. Acute Care Hospital Inpatient Prospective Payment System (I…

…nt Notice final rule, established a methodology for estimating the average per capita premium for purposes of calculating the premium adjustment percentage. Beginning with the 2015 benefit year, the premium adjustment percentage was calculated based on the estimates and projectio…

…the IPPS for Operating Costs 4. Proposed FY 2021 Policy Governing the IPPS for Capital-Related Costs 5. Proposed Changes to the Payment Rates for Certain Excluded Hospitals: Rate-of-Increase Percentages 6. Proposed Changes to the LTCH PPS 7. Proposed Changes Relating to Quality D…

…the IPPS for Operating Costs 4. Proposed FY 2021 Policy Governing the IPPS for Capital-Related Costs 5. Proposed Changes to the Payment Rates for Certain Excluded Hospitals: Rate-of-Increase Percentages 6. Proposed Changes to the LTCH PPS 7. Proposed Changes Relating to Quality D…

…ical therapy services that are provided, in whole or in part, by a physical therapist assistant (PTA) or occupational therapy assistant (OTA). Section 1834(v)(2)(A) of the Act required CMS to establish modifiers to identify these services, which we did in the CY 2019 PFS final ru…

…ical therapy services that are provided, in whole or in part, by a physical therapist assistant (PTA) or occupational therapy assistant (OTA). Section 1834(v)(2)(A) of the Act required CMS to establish modifiers to identify these services, which we did in the CY 2019 PFS final ru…

… Analogous to Office/Outpatient E/M Visits (1) End-Stage Renal Disease Monthly Capitation Payment Services 2. TCM Services (CPT Codes 99495 and 99496) 3. Maternity Services 4. Assessment and Care Planning for Patients With Cognitive Impairment (CPT Code 99483) 5. Initial Preventi…

…ical therapy services that are provided, in whole or in part, by a physical therapist assistant (PTA) or occupational therapy assistant (OTA). Section 1834(v)(2)(A) of the Act required CMS to establish modifiers to identify these services, which we did in the CY 2019 PFS final ru…

…80504, 80505, and 80506) (29) Revaluing End-Stage Renal Disease (ESRD) Monthly Capitation Payment Services (MCP) (CPT Code 90954) (30) Colon Capsule Endoscopy (CPT Codes 91110, 91111, and 91113) (31) External Cardiovascular Device Monitoring (CPT Codes 93228 and 93229) (32) Elect…

…ectronic Health Information (EHI) Export e. Application Programming Interfaces (APIs) f. Privacy and Security Transparency Attestations g. Security Tags and Consent Management 3. Modifications to the ONC Health IT Certification Program 4. Health IT for the Care Continuum 5. Condi…

…ng an Internet-Based Self-Service Tool and Machine-Readable Files in Lieu of an API VI. Collection of Information Requirements A. Wage Estimates 1. ICR Regarding Requirements for Disclosures to Participants, Beneficiaries, or Enrollees ( 26 CFR 54.9815-2715 A2, 29 CFR 2590.715-27…

…ule), which established the rules governing the CO-OP program to make loans to capitalize eligible prospective CO-OPs. In the May 11, 2016 Federal Register ( 81 FR 29146 ), we amended several CO-OP standards related to governance requirements to provide greater flexibility, and t…

…ntions and Predictive Models vi. Synchronized Clocks Standard vii. Standardized API for Patient and Population Services viii. Patient Demographics and Observations Certification Criterion in § 170.315(a)(5) ix. Updates to Transitions of Care Certification Criterion in § 170.315(b…

…ummary of Major Proposals II. Provisions of the Proposed Rule A. Patient Access API 1. Background 2. Enhancing the Patient Access API a. Prior Authorization Information b. Interaction With HIPAA Right of Access Provisions c. Privacy Policy d. Patient Access API Metrics e. Patient…