In May 2020, the federal government announced a rule that increases patient access to health information. Through this rule, health plans must make patient claims data and provider directories available for members in the Medicare, Medicaid and individual markets.
This ruling helps improve the quality and accessibility of information that consumers need to make informed health care decisions.
Meeting requirements
To fulfill interoperability and transparency requirements, Priority Health has partnered with 1upHealth to provide secure patient, provider and third-party access to electronic health data for Patient access API, Provider Directory API. This is in accordance with the Interoperability and Patient Access final rule (CMS-9115-F), which regulates Medicare Advantage (MA), Medicaid, CHIP and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs).
Click here for education on Interoperability and Patient Access final rule (CMS-9115-F).
Click here to get additional educational information on APIs, including Provider Access, Payer-to-Payer API, and Interoperability and Prior Authorization Final Rule.
What does this mean for Priority Health members?
You can now direct the sharing of your medical history and health plan records with other services and applications outside of Priority Health. Active Priority Health members with a member portal login can permit third-party applications to receive the following data:
- All claims and medical history information that is stored and controlled by Priority Health;
- Encounters with capitated providers; and
- Clinical data, including laboratory results (when maintained by the payer)
Using myHealthButton&myHealthPortal to Access Your Information
For Medicaid‑related information, Michigan’s myHealthButton (mobile app) and myHealthPortal (web portal) offer convenient ways to view your:
- Benefits and coverage
- miHealth card
- Immunization records
- Claims history
- Provider information
These tools support the goals of the federal interoperability rules by giving you direct digital access to key health information, helping you stay informed and engaged in your care.