Sliding into the CMS' DMs (again)
Check out Flexpa's comment on prior authorization, provider access to claims data, and payer-to-payer data exchange
Regulation is not a paved path. It is the road uncertain, a collaborative process that requires the input of all stakeholders to find best practice, compromise, and balance. Legislators and regulators are not always in the weeds of the laws and rules they make - they need us to provide insights and input.
Over at Flexpa, we’ve built the leading network to provide consistent, reliable access to claims data with patient’s consent, powering use cases for value-based care providers, payers, fintechs, and clinical trials. In doing so, we’ve seen some shit: custom implementations of SMART on FHIR, OAuth2, and HTTP; developer portals with no one home to answer the phone and approve developers; and outright non-compliance by organizations believing the CMS lacks regulatory chops to enforce their policies.
The road does not get easier and clearer here for payers - it gets harder and more uncertain. So we’ll continue to comment to provide what we know and we’ll chronicle what we learn for others to benefit on the Flexpa substack. Click on through below to read more:
