Interoperability
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 1, 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
Patients
For more guidance on the patient access API and using a 3rd-party application to view your health data, please review the member page.
Developers
To register an app to the Patient Access API, visit OnyxOS
For more information see:
Provider Directory API - Available September 1, 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:
- Name
- Phone number
- Street address
- Zip code
- Type/specialty
- Language
- Status (accepting patients)
Interoperability Rule Regulatory Information
- CMS Interoperability and Patient Access Final Rule
- Executive Order 13813
- Interoperability and Patient Access Fact Sheet | CMS
- CMS Policies and Technology
- CMS Prior Authorization Metrics - March 2026
- CMS Patient Access Metrics - March 2026
For general questions, please contact Andrea.Schroeter@ct.gov.