Mental Health Provider Directories: The Rising Risk of Litigation
Last week, a class action lawsuit was filed in the Southern District of New York against Anthem Blue Cross and Blue Shield, […]
Author: Ron Urwongse
CMS Announces National Directory for Healthcare Pilot in Oklahoma
Yesterday at Health Datapalooza, CMS announced its intent to pilot key components of a National Directory of Healthcare in the state of […]
Using Provider Directory APIs to identify errors in plan directories
“One potentially promising method is to use data analytics to compare health plans’ directories, many of which are available in machine-readable formats […]
HHS report considers the merits of centralized provider directories
In December 2023 the Office of Behavioral Health, Disability, and Aging Policy (within the US Department of Health and Human Services) published […]
State of Provider Directory APIs 2024
Background and Purpose of Analysis In July 2021, CMS required payers with CMS-regulated health plans to publish Provider Directory APIs. In the 3 years […]
Provider Directory API’s Supporting Role in the 2024 CMS Interop Rule
Key Takeaways: Re-Cap of the 2024 Rule Our previous post included a summary of the 2024 CMS Interoperability and Prior Authorization Final […]
A Review of the 2024 CMS Interoperability Rule through the Lens of Directory Use Cases
Yesterday, 13 months after proposing it, CMS finalized its Interoperability and Prior Authorization Rule. As CMS worked towards publishing this rule, payers, […]
The REAL Health Providers Act
Last week, the Requiring Enhanced and Accurate Lists (REAL) of Health Providers Act was introduced by Senators Wyden D-Ore., Bennet D-Colo., and […]
How payers can think about competition as network and price transparency expands
Regulatory Requirements on Network and Price Transparency Transparency-related federal rules are causing a seismic shift in the healthcare industry, compelling payers to […]
Payers are switching Provider Directory API vendors
Two years after the effective date of the CMS Final Rule on Patient Access and Interoperability, payers are reassessing their Provider Directory […]