Gartner Research

Prepare for CMS Interoperability and Patient Access API Compliance for U.S. Healthcare Payers

Published: 15 June 2020

ID: G00725481

Analyst(s): Mandi Bishop


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.

Table Of Contents




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

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