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 Maryland Department of Health to develop a series of application programming interfaces (API).

Patient Access API  - Available November 5, 2021
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
  

Developers
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 July 1, 2021
The provider directory API exchanges provider information between MDH and a search engine or third-party app on a smartphone or other electronic device. The provider information shared includes the following five (5) criteria:

• Name
• Phone number
• Street address
• Zip code
  
• Type/specialty

Developers

Developers who want to connect to and use  the Provider Directory API can visit About the Maryland Medicaid API​.

Interoperability Rule Regulatory Information
CMS Interoperability and Patient Access Final Rule
Executive Order 13813

For general questions, please contact MDH.InteroperabilityRule@maryland.gov.