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Payer-to-Payer Data Exchange
In December 2021, CMS announced enforcement discretion for this policy until identified implementation challenges could be addressed in future rule making;
In an effort to ensure a patient’s data can follow them throughout their health care journey, we are proposing to require that payers would exchange patient data when a patient changes health plans with the patient’s permission. Those data would include claims and encounter data (excluding cost information), data elements identified in the USCDI version 1, and prior authorization requests and decisions. For all impacted payers, we are considering a proposal that would require this exchange only if the patient opts in to data sharing.