CMS mandates that healthcare payers in government programs like Medicare Advantage and managed Medicaid share clinical and claims data with members and member-selected third parties. CIOs must evaluate FHIR API and repository solutions, as well as implement consent management to comply.
Gartner Recommended Reading
Note 1: Regulatory Detail for Data Requirements per Plan Type
Note 2: Links to Relevant Specifications and Implementation Guides
Note 3: USCDI Version 1 Data Classes and Elements