The Centers for Medicare & Medicaid Services’ Patient Access Rule
CMS’s Interoperability and Patient Access Rule requires Medicare, Medicaid, and CHIP health plans to grant electronic access to a member’s health history through a third-party Patient Access API app. The information that is available through the app will include information we collect about you while you have been enrolled in our health plan including:
- Claims data concerning your interactions with health care providers.
- Clinical data that we collect in the process of providing case management, care coordination, or other services to you.
We want you to know that if you choose to disclose your health data through one of these apps, they will have access to all of your information. This might include things like mental health or substance abuse treatment, HIV status, or other sensitive information.
Why do I need to be careful when sharing my information?
- What health data will this app collect?
- How will this app use my data?
- Will this app collect non-health data from my device, such as my location?
- Will this app disclose my data to third parties for purposes such as research or advertising?
- Will this app sell my data for any reason, such as advertising or research?
- Will this app share my data for any reason? If so, with whom? For what purpose?
- Will the app allow me to limit how it uses, discloses, or sells my data?
- What security measures does this app use to protect my data?
- What impact could sharing my data with this app have on others, such as my family members?
- How can I access my data and correct inaccuracies in data retrieved by this app?
- Does this app have a process for collecting and responding to user complaints?
- If I no longer want to use this app, or if I no longer want this app to have access to my health information, how do I terminate the app’s access to my data?
- Is there clear information on how to terminate this app having access to my data?
- What is the app’s policy for deleting my data once I terminate access? Do I have to do more than just delete the app from my device?
- How does this app inform users of changes that could affect its privacy practices?
What is the Health Insurance Portability and Accountability Act (HIPAA)?
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that regulates how personal health information is protected. My Choice Wisconsin is subject to HIPAA laws, as are most health care providers, such as hospitals, doctors, clinics, and dentists. You can find more information about your rights under HIPAA and who is obligated to follow HIPAA here: https://www.hhs.gov/hipaa/for-individuals/index.html.
If you think your HIPAA Privacy Rights have been violated, you may file a complaint with the U.S. Department of Health and Human Services’ Office for Civil Rights at: https://www.hhs.gov/hipaa/filing-a-complaint/index.html.
Are third-party apps required to follow HIPAA rules?
If you believe an app inappropriately used, disclosed, or sold your information, you should contact the FTC. You may file a complaint with the FTC using the FTC complaint assistant: https://reportfraud.ftc.gov/.
App Developers API Support