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HHS/CMS RIN: 0938-AT99 Publication ID: Fall 2020 
Title: Medicaid Programs Reducing Provider and Patient Burden, and Promoting Patients' Electronic Access to Health Information (CMS-9123) 

This proposed rule would place new requirements on state Medicaid and CHIP fee-for-service (FFS) programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of health care data, and streamline processes related to prior authorization, while continuing CMS’ drive toward interoperability, and reducing burden in the health care market. In addition, on behalf of the Department of Health and Human Service (HHS), the Office of the National Coordinator for Health Information Technology (ONC) is proposing the adoption of certain specified implementation guides (IGs) needed to support the proposed Application Programming Interface (API) policies included in this rule. Each of these elements plays a key role in reducing overall payer and provider burden and improving patient access to health information.

Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Yes  Unfunded Mandates: No 
EO 13771 Designation: Regulatory 
CFR Citation: 42 CFR 431    42 CFR 435    42 CFR 438    42 CFR 440    ...     (To search for a specific CFR, visit the Code of Federal Regulations.)
Legal Authority: 42 U.S.C. 1302   
Legal Deadline:  None
Action Date FR Cite
NPRM  12/00/2020 
Regulatory Flexibility Analysis Required: Yes  Government Levels Affected: Local, State 
Small Entities Affected: Businesses  Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: Yes 
Agency Contact:
Alexandra Mugge
Deputy Chief Health Informatics Officer
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Office of the Administrator, MS: C5-02-00, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-4457