November 20, 2020 Program Announcement – What Does Interoperability Mean?

What Does Interoperability Mean?

Understanding Compliance with CMS’s Interoperability and Patient Access Final Rule

Time: 12:00 noon to 1:00 pm

Place: Cisco WebEx

Our speakers will be Susan Russo,AHCCCS, and Melissa Soliz,Coppersmith Brockelman.

Program summary:

The compliance date for the CMS Patient Access API and Provider API requirements is coming soon—January 1, 2021. CMS is exercising its enforcement discretion only until July 1, 2021. And the compliance deadlines for the CMS Conditions of Participation e-notification requirements and payer-to-payer exchange are not far behind. It is imperative that health plans and health care providers understand not only the legal requirements and who must comply, but the challenges with implementing them in compliance with federal privacy laws and practical limitations (such as technology and administrative processes).

Our speakers will cover the CMS final rule requirements for Patient Access API, Provider Directory API, payer-to-payer exchanges, and CMS CoP e-notification requirements. These requirements will be discussed against the backdrop of also complying with federal privacy and patient access law (such as HIPAA, 42 C.F.R. Part 2 and the new ONC Information Blocking Rule) and practical implementation concerns. Specifically, we will cover:

  • The Patient Access API standards, including what must be made available to patients and when;
  • To whom and in what manner covered plans are required to make the Patient Access API available, and the privacy and security concerns this implicates;
  • The Provider API standards, including the use of public facing APIs;
  • When and what level of participation is required in payer-to-payer exchanges, including what health information must be shared and how existing health information exchange (HIE) infrastructures might be leveraged to meet this requirement;
  • What, when and to whom e-notifications must be sent under the new CoPs; and
  • Ancillary topics, such as the requirement for states to send MMA file data daily, interaction with the CIOX decision on limited patient-directed third party disclosures, and Information Blocking compliance.

Program logistics:

Due to the current social distancing recommendations, this program will be held via video conference on November 20, 2020 at 12:00 p.m. through Cisco WebEx.  This program will be $5 for members and $10 for non-members.

To register, please visit our website https://azsha.org/, click upcoming programs, on the right you will see a button that says “Register for Next Program Pay Now”. This button will take you to a screen with multiple payment options. Please select your membership level. If you are a member, please login and proceed with the payment process. If you are not a member, you will have to create a username and password to continue with the payment process. If you are a member, but you paid your annual dues via check rather than online, please reach out to Mackenzie Mayfield to create an account for you, which will allow you to select the membership rate. 

Once you have registered online, you will receive a calendar invite containing the WebEx link. Please note, you don’t need to sign up for a WebEx Account to join a meeting.

The State Bar of Arizona does not approve or accredit CLE activities for the Mandatory Continuing Legal Education requirement. This activity may qualify for up to 1 hour of CLE credit, 0 hours of ethics, toward your annual requirement for the State Bar of Arizona.

Speaker Bios:

Susan Russo, is an in-house attorney at the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s state Medicaid agency. Her work includes drafting language for contracts with health plans, supporting contract oversight, reviewing and advising on new state and federal laws, and representing AHCCCS in administrative hearings and settlement discussions. She has experience in government reimbursement, electronic health records, whistleblower investigations, and health care risk adjustment. Prior to joining AHCCCS, Susan was a consultant in healthcare payer disputes and investigations and clerked on the Arizona Court of Appeals. 

Melissa Soliz is a partner with Coppersmith Brockelman, PLC in Phoenix, Arizona. Her regulatory health law practice focuses on compliance with data privacy and patient access laws (such as HIPAA, 42 C.F.R. Part 2, the ONC Information Blocking Rule, the CMS Interoperability and Patient Access Rule, and state laws), compliance with opioid treatment laws and regulations, health information exchange (HIE), behavioral health/substance use disorder law issues, data breaches and OCR investigations, as well as clinical research compliance and contracting. Melissa regularly speaks in local and national forums on these topics and has been active in state and federal policy making on data privacy and HIE issues.