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Author: Ron Urwongse

August 19, 2024August 20, 2024Policy and Regulation

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

June 24, 2024May 28, 2025Policy and Regulation

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

January 22, 2024Data at Work, Policy and Regulation

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

January 18, 2024January 19, 2024Policy and Regulation

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,

October 26, 2023October 26, 2023Policy and Regulation

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

August 30, 2023August 31, 2023Data at Work

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

July 26, 2023August 30, 2023Developers

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

May 18, 2023June 6, 2023Data at Work

Using Payer APIs to Improve Mental Health Networks

In our last article, we explored mental health ‘ghost’ networks as discussed in the May 3rd Senate Finance Committee hearing. We summarized

May 9, 2023June 6, 2023Policy and Regulation

Understanding Mental Health ‘Ghost’ Networks

This is the first of a two-part series on mental health ghost networks. In the first post, we will assess the information

April 25, 2023June 6, 2023Data Insights

How many payer contracts do providers have?

Knowing the number of payers that providers contract with is important for a few reasons. Reason 1: It is a proxy for

Posts pagination

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