CMS Interoperability and Patient Access Rule
Your Health Information – In One Place
What is Interoperability?
It is like a secure bridge. Interoperability uses secure Application Programming Interface (API) connections (digital messengers) so you can see and share your health information. It also lets your doctors, hospitals, and health plan share your health information safely.
You can pick a trusted third-party health app and request your health information through the app, but there are risks.
- Make sure to always check the third-party application’s privacy policy as they work differently than your doctors, hospitals and health plan. If there is no privacy policy, it is best not to use that third-party app.
- Once the app gets your health information it may not be protected by privacy laws (like HIPAA). That means Advanced Health won’t be responsible for keeping your data safe anymore. But most third-party apps must follow the rules under the Federal Trade Commission (FTC) Act. Which includes rules on mobile app privacy and security. You can read more on the Federal Trade Commission Consumer Advice website about how websites and apps collect and use your information.
- If there are certain records you do not want to share, you should check the third-party app’s privacy settings or reach out to Advanced Health for help.
To learn more about Interoperability and Patient Access rules, please visit CMS’s Patient Access API and Interoperability Ruling (CMS-9115-F).
Your Choice About Sharing Health Information Between Health Plans
- You decide if we ask your last health plan for your health information or share your data with another health plan you have now. You can opt in (say yes) at any time. Your data is not shared automatically.
- Saying yes to sharing your data can help your care go more smoothly. It can help your doctors see a more complete record, reduce gaps in your care, and support better health and a better care experience.
- If you opt in to sharing your data with other health plans, you can change your mind and opt out (say no) at any time.
- If you tell us who your last health plan was, we will ask them for your records so you can see your older and newer records in one place.
- If you have two or more health plans at the same time, we will share your data with your other current plan about every three months. This helps us work together so your coverage fits your needs as well as possible.
- Even if you opt in, we will not share your data with any health plan you are not enrolled in. We only use this data sharing to get information from a past plan, share with a plan you have now, and send information to a future plan when needed.
- Your health information is protected by strong privacy and security steps to help keep it safe.
Important Information to Know
Even if you opt out of sharing your data through these tools, other laws, like HIPAA and state laws, may still allow your doctor to get some information they need to treat you. Your health information is only shared with providers in our network who we show have given you care before.
When you allow your health information to be shared with your doctor, it can help them:
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- Work better with other providers,
- Speed up approvals for your care,
- Help you get care on time, and
- Support better health results for you.
- Your health information is protected by strong privacy and security rules to help keep it safe.
Do You Think Your Information Wasn’t Handled Right?
If you think a third-party app broke its own privacy policy with your health information, tell the Federal Trade Commission. Go to their website to make a report or call 1-877-382-4357.
If you think someone else other than the third-party application has broken a privacy policy or did not handle your health information in the right way, let Advanced Health know by calling 541-269-7400 or toll free 1-800-264-0014; TTY users can call 711 or 1-800-735-1232. You can also tell the Department of Health and Human Services Office of Civil Rights. Visit their website or call 1-800-368-1019.
You can always remove access or block third-party apps from accessing your health information with Advanced Health at any time.
1UpHealth Third-Party App Directory
A list of third-party applications includes apps for patients, providers, and payers approved by 1upHealth and granted access to the 1upHealth Health Plan Patient Access API endpoints.
