Section 1374.196 - [Effective Until 1/1/2025] Health care service plans to maintain certain application programming interfaces (API)(a) Commencing January 1, 2024, to facilitate patient and provider access to health information, a health care service plan shall establish and maintain the following application programming interfaces (API) for the benefit of enrollees and contracted providers, as applicable: (1) Patient access API, as described in Section 422.119 (a) to (e), inclusive, of Title 42 of the Code of Federal Regulations.(2) Provider directory API, as described in Section 422.120 of Title 42 of the Code of Federal Regulations.(3) Payer-to-payer exchange API, as described in Section 422.119(f) of Title 42 of the Code of Federal Regulations.(b) In addition to the API described in subdivision (a), the department may require a health care service plan to establish and maintain the following API if and when final rules are published by the federal government: (2) Prior authorization support API.(c) API described in subdivision (b) shall be in accordance with standards published in a final rule issued by the federal Centers for Medicare and Medicaid Services and published in the Federal Register, and shall align with federal effective dates, including enforcement delays and suspensions, issued by the federal Centers for Medicare and Medicaid Services.(d) This section does not limit existing requirements under this chapter, including, but not limited to, Section 1367.27.Ca. Health and Saf. Code § 1374.196
Added by Stats 2022 ch 888 (SB 1419),s 1, eff. 1/1/2023.This section is set out more than once due to postponed, multiple, or conflicting amendments.