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Developer Resources


The Centers for Medicare and Medicaid Services (CMS) has required that payers of CMS-regulated plans implement and maintain a secure, standards-based Patient Access Application Programming Interface (API) (using Health Level 7® (HL7) Fast Healthcare Interoperability Resources® (FHIR) Release 4.0.1). This Patient Access API allows patients to easily access their claims and encounter information, including cost (specifically provider remittances and enrollee cost-sharing).

This rule also requires payers of CMS-regulated plans to make provider directory information publicly available via a FHIR-based Provider Directory API.

Necessary Technical Documentation

FHIR

Health Level 7 (HL7) Version 4.0.1 Fast Healthcare Interoperability Resources (FHIR) Release 4, October 30, 2019

FHIR Release 4.0.1 provides the first set of normative FHIR resources. This normative designation means that the future changes will be backward compatible. These resources define the content and structure of core health data, which can be used by developers to build standardized applications.

SMART Implementation Guide / OAuth 2.0

SMART Application Launch Framework Implementation Guide Release 1.0.0, November 13, 2018

SMART on FHIR provides reliable, secure authorization for a variety of app architectures through the use of the OAuth 2.0 standard. This Authorization Guide supports the four use cases defined for Phase 1 of the Argonaut Project. This profile is intended to be used by app developers that need to access FHIR resources by requesting access tokens from OAuth 2.0 compliant authorization servers. The profile defines a method through which an app requests authorization to access a FHIR resource, and then uses that authorization to retrieve the resource.

OAuth 2.0

The OAuth 2.0 Authorization Framework

The OAuth 2.0 authorization framework enables a third-party application to obtain limited access to an HTTP service, either on behalf of a resource owner by orchestrating an approval interaction between the resource owner and the HTTP service, or by allowing the third-party application to obtain access on its own behalf. This specification replaces and obsoletes the OAuth 1.0 protocol described in RFC 5849.

USCDI

United States Core Data for Interoperability (USCDI), February 2020, Version 1 (v1)

The USCDI is a standardized set of health data classes and component data elements for nationwide, interoperable health information exchange.

Registering with Shared Health Mississippi

Shared Health Mississippi has created a registration process for third-party app developers who want to connect members through their app. To begin the registration process, send an inquiry email to eBusiness_Service@sharedhealthms.com requesting access to our Patient Access API. Please include the following information:

  • Contact name
  • Company name
  • App title
  • Callback URL to assign to your application
  • Description of the application
  • Any other relevant information

You also need to define the scope that will be used during the authorization process. Shared Health Mississippi has implemented the SMART App Launch Scopes as outlined below.

Scope Grants
patient/*.read Permission to read supported FHIR resources for the current patient
openid fhirUser Permission to retrieve information about the current logged-in user

 

You will be assigned a Client ID and Client Secret after we’ve completed registering your application. The Client Secret needs to be stored securely and should only be used for accessing the Shared Health Mississippi APIs.

Requesting Authorization From a User

The application needs to direct the user to Shared Health Mississippi’s authorization endpoint using the below URL and parameters to authenticate the user and obtain the authorization code.

GET       https://sso.sharedhealthms.com/as/authorization.oauth2

Parameter Value
client_id The Client ID that you received from Shared Health Mississippi
grant_type authorization_code
redirect_uri Your endpoint that receives callback from the Shared Health Mississippi API
scope patient/*.read openid fhirUser
response_type code

Obtaining the Access Token

Once the user completes the authorization step detailed in the previous step, Shared Health Mississippi will return an Authorization Code in the redirect URL that can be exchanged for an Access Token to make calls to Shared Health Mississippi’s FHIR server.

The application needs to send a POST request using the below URL and parameters to obtain the access token.

POST       https://sso.sharedhealthms.com/as/token.oauth2

Parameter Value
client_id The Client ID that you received from Shared Health Mississippi
client_secret The Client Secret that you received from Shared Health Mississippi
grant_type authorization_code
redirect_uri Your endpoint that receives callback from the Shared Health Mississippi API
scope patient/*.read openid fhirUser
code The Authorization Code received in the previous step

 

You can now use this token as the Bearer Token within the request header in your calls to the Shared Health Mississippi FHIR server.

Shared Health Mississippi FHIR API endpoints

API Category Security Requirements API Endpoint(s) Supporting Documentation
FHIR Capability Statement Open access https://api.sharedhealthms.com/fhir/r4/metadata
https://api.sharedhealthms.com/fhir/r4/.well-known/smart- configuration
The metadata endpoint provides the CapabilityStatement resource from the FHIR server.
Patient Access API Application onboarding User authentication and authorization https://api.sharedhealthms.com/fhir/r4/CarePlan
https://api.sharedhealthms.com/fhir/r4/Coverage
https://api.sharedhealthms.com/fhir/r4/Condition
https://api.sharedhealthms.com/fhir/r4/ExplanationOfBenefit
https://api.sharedhealthms.com/fhir/r4/List
https://api.sharedhealthms.com/fhir/r4/MedicationKnowledge
https://api.sharedhealthms.com/fhir/r4/Observation
https://api.sharedhealthms.com/fhir/r4/Patient
https://api.sharedhealthms.com/fhir/r4/Procedure

The Patient Access APIs are used to build applications that allow BlueCross members to access their claims and encounter information, a defined sub-set of their clinical information, and formulary information.

Implementation Guides

Supported Profiles

Provider Directory API Open Access https://api.sharedhealthms.com/fhir/r4/Endpoint
https://api.sharedhealthms.com/fhir/r4/HealthcareService
https://api.sharedhealthms.com/fhir/r4/InsurancePlan
https://api.sharedhealthms.com/fhir/r4/Location
https://api.sharedhealthms.com/fhir/r4/Organization
https://api.sharedhealthms.com/fhir/r4/OrganizationAffiliation
https://api.sharedhealthms.com/fhir/r4/Practitioner
https://api.sharedhealthms.com/fhir/r4/PractitionerRole

The Provider Directory APIs can be used to create applications to access information about providers and pharmacies.

Implementation Guides

Supported Profiles

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Do you have more questions?

For more information about interoperability for app developers, please visit the CMS webpage about the CMS Patient Access Final Rule.

If you have questions about connecting to the Shared Health Mississippi FHIR API, please send any questions in an email with a contact name, company name, app title, to eBusiness_Service@sharedhealthms.com.

We may be directed to give your application access to patient identifying information that is protected by 42 CFR Part 2 (the federal Confidentiality of Substance Use Disorder Patient Records). By registering with our API, you acknowledge and agree that you have received the prohibition on redisclosure notice that 42 CFR Part 2 prohibits unauthorized disclosure of these records.