November 16, 2015

CMS Prioritizing Accuracy Over Urgency in Roll-Out of Online Provider Directories and Drug Formularies

A one-stop interface where consumers can browse the doctors, facilities and drug formularies in each health plan in the federal health insurance exchange was supposed to go live Nov. 1. But, as explained in Inside Health Insurance Exchanges, the federal tool is not yet ready to be deployed, as health plans have struggled to meet the Centers for Medicare and Medicaid Services (CMS) requirements to supply data according to the government's new “machine-readable" specifications. Mike Adelberg, senior director for FaegreBD Consulting, said that a sluggish start stems from a desire to ensure accuracy of the data before fully implementing the tool. Instead, the machine-readable provider directories and drugs formularies are being rolled out in stages.

“Prognosticators always knew that getting machine readable right by Nov. 1 was very ambitious. It makes sense to go slow and get the data right,” Adelberg said. “When the data is ready, it will power important decision tools. Until then, it is best to wait.”

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