CMS Rule Interoperability Mandate for Payers

1upHealth’s FHIR API Platform is the first true implementation of the ONC’s intent for healthcare interoperability.
Cool Vendor Report 2020

CMS Interoperability Final Rule

CMS recently introduced new interoperability mandates for health plans that must be implemented by July 1, 2021. These include:

  • Patient Access Rule - FHIR for members to share data with apps
  • Provider Directory API - FHIR API for a provider directory
  • Payer to Payer Data Exchange - Send and receive member data with other plans (Jan 2022)
  • Read more CMS patient access and interoperability requirements.

    1upHealth Solution

    1upHealth provides a fully managed solution to cover all new mandates. Our customers, including plans with millions of members, are already in production with 1up’s HHS award-winning API platform. Today, 100s of apps use 1up FHIR APIs to manage user directed connectivity across 1000s of health systems that we helped attest to similar patient access mandates. Plans can use the same infrastructure to meet all patient access and interop requirements.

    Integrated FHIR Platform as a Service

    Meet all CMS Mandates

    Patient Access APIs
    Public Provider Directory API
    Payer to Payer Data Exchange

    Demonstrated Security

    1st place in ONC’s Secure FHIR Server Challenge
    HIPAA Compliant
    SOC 2 Audited

    Go live on time with ease

    Solution is already built, in production
    No additional integrations needed
    Quick 9 week implementation
    Fully, managed cloud deployment
    Simple pricing (per member per year) without license fees

    1up leads FHIR interop

    1up is literally setting the standard with HL7
    Built the CARIN FHIR App Gallery
    Built the Bulk Data Analytics Reference
    Founding members of FHIR Business Alliance

    You'd be crazy to work with other vendors

    Only 1up is in production for all CMS requirements
    Only 1up has a patient app network
    Only 1up has 1000s of direct FHIR connections to health systems
    Only 1up received numerous FHIR awards from the US Government



    FHIR Connected health centers



    Healthcare companies on 1upHealth APIs



    Transactions processed per second



    Government awards in healthcare IT


    10M +

    Lives under contract


    All the features above are required to ensure success and security when meeting the new rules. Health plans must consider a broad list of interoperability, deployment, and support aspects to meet these mandates. 1up has everything health plans need to meet the regulations. You have flexibility and options with our platform and services and can utilize one module, a-la-carte, or the full solution for end-to-end use cases.

    Why 1upHealth

    1upHealth is well positioned to support health plans in meeting the CMS requirements for the July 2021 deadline.

    Direct Payer Experience

    We have direct experience through our work with as one of the first approved Blue Button 2.0 apps, with health plans supporting millions of health plan members and the Da Vinci Project through workgroups and connectathons.

    Extensive Clinical Data Network

    We've worked with 100s of health systems across the US in meeting Meaningful Use 3 (MU3) requirements. We’ve now connected to 10,000+ hospital and health centers, allowing patients to authorize access to their EHR medical records with 3rd party applications.

    We are FHIR Experts

    Our team is comprised of leading FHIR experts who have presented alongside CMS and ONC leaders like Don Rucker, had led HL7 standard balloting, and participate in numerous FHIR connectathons

    Proven Platform for Regulation

    Because our award-winning FHIR solution is already in production, we can ensure timely deployment and meeting the requirements of the new rules.