2020-06-02 Meeting Agenda/Minutes

Access to data from a prior payer where someone was previously an enrollee:

Bob - per the CMS rule, payers are only REQUIRED to provide access to data to active members.  If that individual ceased to be an enrollee, the CMS rule does not require that payer to continue to provide access to those records, but the payer could choose to do so.

Prior payers are required to share clinical data (USCDI) with other payers, so the current payer could request clinical data from the prior payer, and then supply that aggregated clinical data to the member.

Bob - generally, when a member ceases to be a member for a payer, they will lose access to that payers resources, including web portal, etc.

Original intent with the STU update was to take some language from the Periodontal/Orthodontic guides and include it in this IG to be referenced for all Attachments.

We've received some more comments beyond this planned scope