A closer look at Cures Act 2021 API requirements

Stephanie St. Thomas
December 7, 2020

APIs (application programming interfaces) promise to transform healthcare.

Their growing use is driven by consumer expectations and a federal law, the 21st Century Cures Act.

Because of the pandemic, the federal government has extended several different deadlines for APIs required by the Cures Act in 2021.

The Cures Act and APIs

Signed into law in 2016, the Cures Act is designed to bring medical and technology advancements to patients more quickly—including better access to healthcare information. One of the key ways that health information exchange will grow is through APIs, which securely share data across different websites and applications, and are widely used within consumer-facing websites and cellphone apps.

The Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare and Medicaid Services (CMS) are each responsible for carrying out provisions of the Cures Act.

Separate requirements from the ONC and CMS

In March, CMS and the ONC each issued rules requiring use of APIs that give consumers’ access to their own health information, to provider data, and to information about healthcare costs.  

The ONC is responsible for the ONC Cures Act final rule and sets overall technical standards for the required APIs.

CMS is overseeing the CMS Interoperability and Patient Access final rule.

Here is a closer look at the Provider Directory API requirement.

Provider Directory APIs

While preparing for APIs, health plans are prioritizing the quality and accuracy of their provider data, since data quality will be transparent to consumers. Whenever a change is made to the plan’s provider directory, CMS also requires that data is updated within 30 business days. Plans that exceed this timing will also build trust with consumers, who have come to expect real-time accuracy from data.

With provider data available through APIs, health plans have the opportunity to create new apps and user experiences for consumers, building loyalty and becoming a preferred portal to care, quality and cost information, and more.

Learn more about the provider directory API requirement by viewing the rule in the federal registry.

Helping customers navigate APIs and provider data

Ribbon Health is helping health plans and digital health companies navigate the intersection of APIs and provider data. We provide customers with access to a national database of provider data of the highest quality and accuracy, available through standards-based APIs. Health plans use this data to augment and strengthen their provider data directories. That way, consumers can make healthcare decisions that are high-quality, cost-effective, and convenient.

Provider organizations are also finding that comprehensive provider data is an asset for virtual care initiatives and for the development of digital front doors.

Learn more about how Ribbon Health helps health plans and providers prepare provider data for new levels of consumer access and use.

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