As part of the 21st Century Cures Act regulations, the Centers for Medicare and Medicaid (CMS) policy requires that systems be put in place to make it easier for Medicare Advantage members to see important health data. Members will be able to use a third-party mobile app or online tool to view health claims information, including treatment and prescription history and costs; find an up-to-date list of in-network providers; and see which providers have agreed to provide electronic access to health information.
It is important to take an active role in protecting your health information. Below, please find a checklist of things to consider when choosing a third-party mobile app or online tool. You should look for an easy-to-read privacy policy that clearly explains how your data may be used.
Consider the following when evaluating options:
What are your rights under the Health Insurance Portability and Accountability Act (HIPAA) and who must follow HIPAA?
The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) enforces the HIPAA Privacy, Security, and Breach Notification Rules, and the Patient Safety Act and Rule. You can find more information about your patient rights under HIPAA and who is obligated to follow HIPAA here.
You can also reference HIPAA FAQs for Individuals.
Are third-party apps covered by HIPAA?
Most third-party apps will not be covered by HIPAA. Most third-party apps will instead fall under the jurisdiction of the Federal Trade Commission (FTC) and the protections provided by the FTC Act. The FTC Act, among other things, protects against deceptive acts (e.g., if an app shares personal data without permission, despite having a privacy policy that says it will not do so).
The FTC provides information about mobile app privacy and security for consumers here.
What should you do if you think your data has been breached or an app has used your data inappropriately?
If you believe your privacy rights have been violated, please make us aware by calling Member Services at 1-866-544-7504 (TTY: 711), 8 am to 8 pm, seven days a week from October 1–March 31, and Monday through Friday the rest of the year, to discuss your situation. Our team can provide assistance on the steps that need to be followed and where to file a complaint:
To read more about the CMS ruling and the 21st Century Cures Act, visit: https://www.cms.gov/newsroom/fact-sheets/interoperability-and-patient-access-fact-sheet
To access the Martin's Point Generations Advantage provider directory API please click here.
To access the Martin's Point Generations Advantage formulary API please click here.