Interoperability: Developer access to APIs and Smart on FHIR

CMS Interoperability and Patient Access Final Rule

The interoperability and Patient Access final rule (CMS-9115-F) puts patients first by giving them access to their health information when they need it most, and in a way they can best use it. This final rule is focused on driving interoperability and patient access to health information by liberating patient data using CMS authority to regulate Medicare Advantage (MA), Medicaid, Children's Health Insurance Program (CHIP) and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs).

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About FHIR Version 4.0.1

FHIR Release 4.0.1 provides the first set of normative FHIR resources. A subset of FHIR resources is normative, and future changes on those resources marked normative will be backward compatible. These resources define the content and structure of core health data, which developers use to build standardized applications.

HL7 Version 4.0.1 FHIR Specification Release 4

Best Practices for Payers and App Developers

This document includes links to useful information and best practices to help payers and developers build and maintain a FHIR-based API, as well as best practices for third-party app developers.

Best Practices for Payers and App Developers (PDF)

Outages for Scheduled Maintenance

We rely on several API vendors to support our API fulfillment. From time to time, one of these partners' systems may be down for scheduled maintenance for up to 12 hours. During these times, our API will still be active and responding to requests. However, some API calls may result in failures or no data being returned.

We apologize for the inconvenience. If you've had data issues for an extended period, please call us at (651) 662-1758 or 1-800-333-1758.

Patient Privacy and Security Resources

This document provides an overview of what is required to be included in a payer’s patient resource document and some content payers may choose to use to help meet this requirement. Use of this document is not required; it is to support payers as they produce patient resources tailored to their patient population.

Patient Privacy and Security Resources (PDF)

Smart on FHIR

See our info about Smart on FHIR

Go to Smart on FHIR info

Patient Access APIs

Learn about and use our Patient Access APIs

Go to Patient Access APIs

Provider Directory APIs

Learn about and use our Provider Directory APIs

Go to Provider Directory APIs

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