Young doctor using AI to analyze valuable data about individual patients collected via wearables and personal devices. Health care and technology concept for artificial intelligence and telemedicine.
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In order to better facilitate coordination of care, and support movement toward value-based payment models, we are proposing to require impacted payers to build and maintain a Provider Access API to share patient data with in-network providers with whom the patient has a treatment relationship. We are proposing that they make patient claims and encounter data (excluding cost information), data elements identified in the United States Core Data for Interoperability (USCDI) version 1, and prior authorization requests and decisions available to in-network providers beginning January 1, 2026.