Through the
Interoperability and Patient Access Rule, the Centers for Medicaid and Medicare Services (CMS) has required Medicare Advantage (MA), Medicaid, Children's Health Insurance Program (CHIP), and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to make payer claims, provider directory and formulary data available via FHIR APIs.
For most states, this is the first publicly-facing API we have ever built.
If integrating with Medicaid claims data is on your roadmap, we'd love to hear from you.
This will help states understand what you need from a developer portal, how you would leverage these APIs to help Medicaid members and more.
Thanks!
- The Colorado Medicaid Team