Provider Access to Data Crucial Next Step for Improved Interoperability; Congress Has Opportunity to Build on API Rules

Alexandria, VA – AMGA today recommended that the Centers for Medicare & Medicaid Services (CMS) build on its recent interoperability final rule to give providers access to patient data. The CMS final rule, which was released in conjunction with an Office of the National Coordinator for Health Information Technology (ONC) final rule, would require organizations operating Medicare Advantage, Medicaid, the Children’s Health Insurance Program (CHIP), and Affordable Care Act (ACA) exchange plans to share claims data electronically with patients through an application programming interface. AMGA is appreciative of CMS’ efforts to empower patients to access their own data. However, providers still need seamless access to this information to care for their patient populations.

“Provider access to patient data is required in a system where organizations agree to be held accountable for the cost and quality of care for a defined population,” said AMGA President and CEO, Jerry Penso, M.D., M.B.A. “AMGA’s members strongly believe in population health and the move to value-based care as a means to create a healthier society. Access to claims data allows our members to continue this shift and provide high-quality care to the communities they serve.”

AMGA continues to work with key House and Senate leadership to secure support for legislative action to ensure providers have access to patients’ claims data. Section 501, which was a part of the Lower Health Care Costs Act, would require payers to share claims data with providers. This section would be the last crucial link to ensuring patients and providers have complete information and would complement the ONC and CMS efforts. 


About AMGA
 AMGA is a trade association leading the transformation of health care in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans.


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