42 CFR § 438.242
[Amendment] Health information systems
June 11, 2020
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(b) * * *
(5) Implement an Application Programming Interface (API) as specified in §431.60 of this chapter as if such requirements applied directly to the MCO, PIHP, or PAHP and include—
(i) All encounter data, including encounter data from any network providers the MCO, PIHP, or PAHP is compensating on the basis of capitation payments and adjudicated claims and encounter data from any subcontractors.
(ii) [Reserved]
(6) Implement, by January 1, 2021, and maintain a publicly accessible standards-based API described in §431.70, which must include all information specified in §438.10(h)(1) and (2) of this chapter.
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