CMS Finalizes Rule Giving Providers and Employers Improved Access to Information for Better Patient Care

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The Centers for Medicare & Medicaid Services (CMS) finalized new rules expanding access to analyses and data that will help providers, employers, and others make more informed decisions about care delivery and quality improvement. The new rules, as required by the Medicare Access and CHIP Reauthorization Act (MACRA), allow organizations approved as qualified entities to confidentially share or sell analyses of Medicare and private sector claims data to providers, employers, and other groups who can use the data to support improved care. In addition, qualified entities may provide or sell claims data to providers and suppliers, such as doctors, nurses, and skilled nursing facilities among others. The rule also includes strict privacy and security requirements for all entities receiving patient identifiable and beneficiary de-identified analyses or data, as well as expanded annual reporting requirements. For example, if entities receive patient identifiable data or analyses, they must use protections that are at least as stringent as what is required of covered entities and their business associates for protected health information (PHI) under the HIPAA Privacy and Security Rules.