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Interoperability and Patient Access

The Centers for Medicare & Medicaid Services Interoperability and Patient Access final rule requires Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to implement and maintain a secure, standards-based Patient Access Application Programming Interface (API). This will allow members to have easy access to their own health information and opportunity to allow others permission to access that health information.

For more information, please read the CMS fact Sheet. This will open in a new window.Interoperability and Patient Access Fact Sheet | CMS

There are two main components for the Interoperability Guidelines

Patient Access to claims and cost including clinical health care data and encounter information. Provider Directory to ensure members are able to find providers and treatment easily. Aspirus Health Plan is continuing to move forward and in the coming weeks will be providing more information to educate our members regarding the policies, protocols and risks for data sharing.


Aspirus provides APIs for developers to create third party applications. Please use the instructions below to use the APIs that comply with the CMS interoperability rule.