In 2020, the Centers for Medicare and Medicaid Services (CMS) passed a rule requiring health insurers to make it easier for patients to access their health care, including prices, and for providers to report this information. CMS purpose is to improve quality and access to health information, allowing Medicaid participants and their providers to make informed health care decisions. The CMS rule requires the Connecticut Department of Social Services to develop a series of application programming interfaces (API).
Patient Access API - Available September 8, 2022
The patient access API enables Medicaid participants to allow a 3rd-party app to access their health information. Participants can download a registered app(s) to their smartphone or other electronic device to access:
- Claims data
- Pharmacy formulary information
To review available apps or cancel apps that access your health data, visit the patient portal.
For guidance on using the patient portal, please review the patient portal guide.
To register an app to the Patient Access API, visit SAFHIR.
For more information see:
- How to Register as a Third-Party App
- Submitting an App for Approval
- View the Carin Blue Button metadata
- View the pharmacy formulary metadata
Provider Directory API - Available September 8, 2022
The provider directory API exchanges provider information between DSS and a search engine or third-party app on a smartphone or other electronic device. The provider information shared includes the following seven (7) criteria:
- Phone number
- Street address
- Zip code
- Status (accepting patients)
Developers who want to connect to and use the Provider Directory API can visit About the Connecticut Medicaid API.
Interoperability Rule Regulatory Information
For general questions, please contact Andrea.Schroeter@ct.gov.