CMS Program to Give Providers Access to Medicare Patient Data

In an effort to accelerate the transformation of the nation’s healthcare system to one that is value-based, the Centers for Medicare & Medicaid Services (CMS), recently launched the Data at the Point of Care (DPC) pilot program.

The pilot program, announced by CMS Administrator Seema Verma during a Blue Button Developer Conference, will give healthcare professionals direct access to Medicare claims data including a beneficiary’s previous diagnoses, past procedures, hospital and emergency department utilization, and medication lists. The idea is that if you give clinicians more complete information about a patient’s health upfront, they can spend more time with the patient and less time on paperwork.

Launched in October 2010, Blue Button allows patients to view and download their personal health records online. Last year, CMS announced Blue Button 2.0 to create a claims-based application programming interface (API) for Medicare beneficiaries, allowing them to connect their data to apps and other tools created by developers.

“Blue Button 2.0 has provided better access to this data for patients, but now CMS is going a step further and helping to connect clinicians to their patients’ information,” Verma, said in a prepared statement.

CMS said its goal is to launch the first DPC data exchanges in September 2019 with a few provider organizations that have demonstrated that they are prepared to test the process. The information can be accessed in the existing workflow and without logging into another application or portal, according to CMS. There is no cost associated with accessing the data.

In February, CMS issued the Interoperability and Patient Access Proposed Rule, which would require all government and commercial health plans regulated by the rule to follow CMS’s lead with Blue Button 2.0 by making data available on 85 million patients, including those covered by Medicare Advantage, Medicaid, CHIP and health plans sold on the federal exchanges.

In April, CMS extended the comment period on the rule for another 30 days to “maximize the opportunity for meaningful input and further the overall objective to obtain public input on the proposed provisions to move the healthcare ecosystem in the direction of interoperability.”

Clinicians interested in taking part in DPC pilot program can sign up by visiting:

The Health Law Offices of Anthony C. Vitale can assist clients with filing the appropriate paperwork to participate in the pilot program and with analyzing the CMS data. Give us a call at 305-358-4500 or send an email to and let’s discuss how we might be able to assist you.

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The Health Law Offices of Anthony C. Vitale

The Health Law Offices of Anthony C. Vitale