Update cms.rst

compliance/cms.rst

@@ -1,59 +1,64 @@
 .. _cms:
 
-Compliance with CMS Advancing Interoperability and Improving Prior Authorization Processes - 🇺🇸
-===============================================================================================
+CMS Advancing Interoperability and Improving Prior Authorization Processes (CMS-0057-P) - 🇺🇸
+============================================================================================
 
-The CMS Interoperability Rule aims to promote greater interoperability, patient access, and innovation in the healthcare industry, while also improving the quality and cost-effectiveness of care. Technically these goals are supported by multiple APIs that are required to be provided:
+The proposed `CMS Interoperability Rule (CMS-0057-P) <https://www.federalregister.gov/documents/2022/12/13/2022-26479/medicare-and-medicaid-programs-patient-protection-and-affordable-care-act-advancing-interoperability>`_ aims to promote greater interoperability, patient access, and innovation in the healthcare industry, while also improving the quality and cost-effectiveness of care. Technically these goals are supported by multiple APIs that are required to be provided:
 
-* Patient Access API
-* Provider Access API
-* Provider Directory API
-* Payor-to-Payor API
-* Prior Authorization Requirements, Documentation and Decision (PARDD) 
+Firely Server aims to support all mandatory requirements out-of-the-box. The following implementation guides built the foundation of the APIs mentioned above.
 
-Firely Server aims to support all mandatory requirements out-of-the-box. The following ImplementationsGuides built the foundation of the APIs mentioned above.
-
-.. list-table:: Firely Server CMS Interoperability Mandatory IGs
+.. list-table:: Firely Server Compliance CMS Interoperability Mandatory IGs
    :widths: 10, 10, 10, 10, 10
    :header-rows: 1
 
    * - API
      - FHIR v4.0.1
-     - :ref:`US Core<compliance_g_10>`
-     - :ref:`SMART App Launch<feature_accesscontrol>`
-     - :ref:`Bulk Data Access<feature_bulkdataexport>`
+     - :ref:`us_core_ig`
+     - :ref:`smart_app_launch_ig`
+     - :ref:`bulk_data_access_ig`
 
-   * - * Patient Access API
+   * - Patient Access API
 
-     - X
-     - X
-     - X
+     - ✅ 
+     - ✅ 
+     - ✅ 
      - Not needed
 
-   * - * Provider Access API
+   * - Provider Access API
 
-     - X
-     - X
-     - X
-     - X
+     - ✅ 
+     - ✅ 
+     - ✅ 
+     - ✅ 
 
-   * - * Provider Directory API
+   * - Provider Directory API
 
-     - X
-     - X
-     - X
+     - ✅ 
+     - ✅ 
+     - ✅ 
      - Not needed
 
-   * - * Payor-to-Payor API
+   * - Payor-to-Payor API
 
-     - X
-     - X
-     - X
-     - X
+     - ✅ 
+     - ✅ 
+     - ✅ 
+     - ✅ 
 
-   * - * PARDD API
+   * - PARDD API
 
-     - X
-     - X
-     - X
+     - ✅ 
+     - ✅ 
+     - ✅ 
      - Not needed
+
+Patient Access API
+------------------
+
+Impacted payers (see `CMS definition <https://www.cms.gov/about-cms/obrhi/interoperability/faqs/patient-access-api#footnote-01>`_) are required to make claims, encounter and clinical data, including laboratory results available through the Patient Access API.
+The goal is to to make as much data available to patients as possible through the API to ensure patients have access to their data in a way that will be most valuable and meaningful to them. The following information should be provided via Patient Access API using the corresponding implementation guides:
+
+* Claim details and encounters (see :ref:`carin_ig`)
+* Clinical data incl. laboratory data (see :ref:`us_core_ig`)
+* Plan Coverage and Formularies (US Drug Formulary)
+* Prior Authorization Decisions (Da Vinci Prior Authorization Support)