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, […]
Category: Policy and Regulation
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 […]
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 […]
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 […]
Provider Directory APIs: Beyond a Compliance-Only Mindset
State of Payer Compliance on Provider Directory APIs It has been 18 months since the July 2021 effective date of the CMS […]
Responses to the CMS RFI on National Healthcare Directory
In response to CMS’s RFI on a National Healthcare Directory (responses were due Thurs 12/6/2022), over 600 responses were submitted (around 50% […]