Your Personal Health Data
Your personal health data is available to you when and where you need it. We believe your health data, such as electronic health records, should be available and accessible to you with your consent. You bank or shop online, and can get a degree online, therefore, it makes sense that you can get a complete view of your health information online, too.
What’s Available to You
- Easily retrieve all healthcare data that is meaningful or actionable and share that information securely with whom you choose.
- Be able to use apps or devices to access your healthcare data to better understand, analyze, track, and manage your healthcare needs.
What Is Interoperability?
It is the ability of different information systems, devices, and apps to access, exchange, integrate, and cooperatively use data in a coordinated manner within and across organizations to provide timely information. Interoperability empowers you to have access to your healthcare data easily, whenever you need it.
The Centers for Medicare & Medicaid Services (CMS) put forth new rules that create a more consistent framework for interoperability. They shifted the responsibility of your healthcare data to you as the member and owner of that data. Part of this change includes a simplified and consistent mechanism for apps to ask you for your permission to access your data.
Who Is Eligible To Access Their Health Data Through Interoperability?
Blue Cross® Blue Shield® of Arizona (BCBSAZ) and Health Choice are required to provide access to individuals on Qualified Health Plans (Marketplace plans only), Medicare Advantage plans and Medicaid (AHCCCS) plans.
Accessing Your Data
BCBSAZ and Health Choice are required to provide a “Patient Access API.” This provides a simple way for apps to access your data when you allow them to do so. No app can access your data through the “Patient Access API” without your explicit permission.
Accessing your data is easy and secure. Visit the Interoperability Portal to sign up for the account or sign in if you have already created an account. Access is available to BCBSAZ members on Qualified Health plans and Medicare Advantage plans and for Health Choice members on Medicaid (AHCCCS) plans and Blue Pathway (HMO D-SNP) plans.
The information available through the Patient Access Application Programming Interface (API) includes information we collect about you while you have been enrolled in certain lines of business since January 1, 2016. The information is available for as long as we maintain it in our records and includes:
- Claims and “encounter” data concerning your interactions with healthcare providers.
- Clinical data that we collect in the process of providing case management, care coordination, or other services to you. “Encounter” data is information about office visits and other interactions with providers that are paid for under a monthly or annual fee that BCBSAZ and Health Choice pays a provider for furnishing care to members.
- The information we will disclose may include information about treatment for Substance Use Disorders, mental health treatment, HIV status, or other sensitive information.
What Are Your Responsibilities with Interoperability?
You are responsible for the sharing of your data. Centers for Medicare & Medicaid Services (CMS) rules on interoperability limit what health insurance companies can do to stop apps from asking you to access your health data.
Things You Should Consider When Selecting an App to Share Your Data
At this time there are no third party applications (Apps) available in the marketplace that will allow you to connect to your data. Once Apps become available, you will need to go to your App store and select a preferred App.
- Will this app sell my data for any reason?
- Will this app disclose my data to third parties for purposes such as research or advertising?
- How will this app use my data? For what purposes?
- Will the app allow me to limit how it uses, discloses, or sells my data?
- If I no longer want to use this app, or if I no longer want this app to have access to my health information, can I terminate the app’s access to my data? If so, how difficult will it be to terminate access?
- What is the app’s policy for deleting my data once I terminate access? Do I have to do more than just delete the app from my device?
- How will this app inform me of changes in its privacy practices?
- Will the app collect non-health data from my device, such as my location?
- What security measures does this app use to protect my data?
- What impact could sharing my data with this app have on others, such as my family members?
- Will the app permit me to access my data and correct inaccuracies?
- Does the app have a process for collecting and responding to user complaints?
Covered Entities and HIPAA EnforcementThe U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) enforces the HIPAA Privacy, Security, and Breach Notification Rules. BCBSAZ and Health Choice is subject to HIPAA as are most healthcare providers, such as hospitals, doctors, clinics, and dentists. You can find more information about your rights under HIPAA and who is obligated to comply with HIPAA for individuals.
How to File a Complaint
To learn more about filing a complaint with OCR related to HIPAA requirements, visit U.S. Department of Health & Human Services website.
Apps and Privacy Enforcement
An app generally will not be subject to HIPAA. An app that publishes a privacy notice is required to comply with the terms of its notice, but generally is not subject to other privacy laws. The Federal Trade Commission Act protects against deceptive acts (such as an app that discloses personal data in violation of its privacy notice). An app that violates the terms of its privacy notice is subject to the jurisdiction of the Federal Trade Commission (FTC). The FTC provides information about mobile app privacy and security for consumers. If you believe an app inappropriately used, disclosed, or sold your information, you should contact the FTC. You may file a complaint with the FTC using the FTC complaint assistant.
For App Developers
If you are a third-party developer seeking information on connecting your interoperability-capable application to our platform, please click here. The base URL for our APIs is https://azblue.innovaccer.com/fhir/
Medicaid MCOs: 42 C.F.R. § 438.242(b)(5) (by reference to 42 C.F.R. § 431.60(f));
CHIP MCOs: 42 C.F.R. § 457.1233(d)(2) (by reference to 42 C.F.R. § 457.730(f)); and
QHP Issuers on FFEs: 45 C.F.R. § 156.221(g).