Pennsylvania is helping to support new Federal rules that make it easier for people on Medical Assistance to access their health information.
These rules are part of the 21st Century Cures Act and other recent updates. Now, eligible Medical Assistance beneficiaries can use any approved third-party app to view their Medical Assistance claims and health data electronically.
Medicaid recipients in PA can use third-party apps to access their Healthcare data electronically
- If you are enrolled in Medicaid Fee for Service keep reading for more information.
- If you are using a PA (MCO) Managed Care Organization for your insurance, contact your MCO Provider to obtain information on their approved Third-Party (Apps) Applications.
Important things Beneficiaries should know before deciding to use a Third-Party App for their health care information.
- The Commonwealth of Pennsylvania does not encourage the use of any specific App.
- Beneficiaries must actively work to protect their health information.
- Beneficiaries should find an easy-to-read privacy policy that clearly explains the way the App uses your information.
- Your private protected health information is in danger of being used or seen by someone other than you or your doctor if you use a Third-Party App that does not have a Privacy Policy.
Be sure to READ the Third-Party App’s policies so you are confident the App is protecting your private health information. Health information is your private information, and Beneficiaries should carefully choose an App with strong privacy and security standards to protect your private health information.
Provider / Pharmacy Information on Interoperability
Providers seeking more information on API connectivity should reference the following links.
Developers of Third-Party Applications
Third-Party Application Developers with an interest in becoming certified though our Interoperability Vendor Please visit 1upHealth's CMS Patient Access Rule.
Tips to Keep Health Information Secure
The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) enforces the HIPAA Privacy, Security, and Breach Notification Rules, and the Patient Safety Act and Rule. You can find more information about patient rights under HIPAA and who is obligated to follow HIPAA here: Individuals’ Right under HIPAA to Access their Health Information | HHS.gov
HIPAA FAQs for Individuals: https://www.hhs.gov/hipaa/for-individuals/faq/index.html
Most Third-Party Apps will not be covered by HIPAA. Third-Party Apps will fall under the jurisdiction of the Federal Trade Commission (FTC) and the protections provided by the FTC Act. One area of The FTC Act is protections against dishonest acts (e.g., if an App sharing your personal information without permission, even when the app has a privacy policy that says it will not share your information). The FTC provides information about mobile App privacy and security for consumers here: https://www.consumer.ftc.gov/articles/0018-understanding-mobile-apps
- You may submit a complaint to Office for Civil Rights (OCR) or Federal Trade Commission (FTC), as appropriate. To learn more about filing a complaint with OCR under HIPAA, visit: https://www.hhs.gov/hipaa/filing-a-complaint/index.html
- Individuals can file a complaint with OCR using the OCR complaint portal: https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf
- Individuals can file a complaint with the FTC using the FTC complaint assistant: File A Complaint | Federal Trade Commission (ftc.gov)
Frequently Asked Questions
Accessing your health information through a health app can help you take control of your healthcare and share the information with your doctor or caregiver.
The 2016, 21st Century Cures Act allows you to access your health information using your preferred approved Third-Party Health App. Be sure to check the approved Health App list above for the most current list of Third-Party Health Apps.
Through your phone's Health App, you can:
- Securely see your Medical Assistance health information and history. *
- Manage and make better decisions about your health care from a single location.
- Share your health information with doctors, caregivers, or others by showing them health details on your phone. Depending on the Health App you choose, additional information, sharing features and the ability to view health information on other devices may be available. *
*Different Third-Party health applications may have different information, displays and available features. Each health app decides what information and services to provide. Some providers may also have websites. Check the list for all currently approved Third-Party health apps.
As a Medical Assistance Fee for Service Beneficiary, you will have access to your health information dating back to Jan. 1, 2016. Depending on the Health Application you download to your phone, different features and information may be available. Each approved Third-Party Health Application works hard to create the best user experience for you. Health Application features may vary depending on the Application you choose. Each Health Application determines what information is provided and services offered.
If you have PA Medical Assistance and are enrolled with PA Managed Care Organization for your insurance, you will need to contact your Managed Care Organization Insurance Provider’s approved Third-Party Applications to determine what information they will display.
You will need to have one of the Pennsylvania Medical Assistance approved Health Apps on your phone. You can download a Health App from your app store. The process is the same as loading any other App to your phone from the Apple Store or Google Play. Only approved Health Apps will show your health information.
Contact your selected Third-Party Applications for Health Plan Members (1up.health) for assistance.
Contact your selected Third-Party Applications for Health Plan Members (1up.health) for assistance.
Contact your selected Third-Party Applications for Health Plan Members (1up.health) for assistance.
You may call the Fee for Service Beneficiary Service Center at 1-800-537-8862