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Connecting Your Health Care

New Options for Managing Your Digital Medical Records

Imagine:

  • You go to a new health care provider because you don't feel well and that provider can pull up your health history for dates of service January 1, 2016 and later.
  • The provider uses that information to diagnose you and quickly finds the right specialist by checking an up-to-date provider directory.
  • You have a question about a claim, so you go to your computer, smartphone or tablet and see if it's paid, denied, or still being processed.

Starting in 2021, a new federal rule will make it easier for California Health & Wellness members to do all of this and more.1

The Interoperability and Patient Access rule (CMS-9115-F) puts patients first by giving you control and easy access to your health information when you need it most. Complete access to your health information helps you manage your health better and know what health care resources are available to you.

The New Rule Makes Finding Information Easy2:

  • claims (paid and denied)
  • past test results
  • your cost of care
  • healthcare providers
  • provider appointments
  • health status
  • certain parts of your clinical information
  • pharmacy directory data3

What Types of Medical Information Can I Likely See?

  • first name
  • last name
  • previous name
  • middle name
  • suffix
  • birth sex
  • date of birth
  • race
  • ethnicity
  • preferred language
  • substances (medications)
  • substances (drug class)
  • reaction
  • current address
  • previous address
  • phone number
  • phone number type
  • email address
  • consultation note
  • discharge summary note
  • history & physical
  • imaging narrative
  • laboratory report findings
  • pathology report findings
  • procedure note
  • progress note
  • body height
  • body weight
  • BMI percentile (2-20 years)
  • blood pressure
  • heart rate
  • respiratory rate
  • body temperature
  • Vaccines
  • Procedures
  • Medications
  • Laboratory Tests & Results
  • Assessment & Treatment Plan
  • Care Team Members

1Applies to Medicare Advantage, Medicaid and CHIP Managed Care, and federally funded ACA exchange plans.

2Data will be available for dates of service on or after Jan. 1, 2016.

3For Medicare Advantage Prescription Drug (MAPD) plans.

*Vital Signs maintained by the Health Plan will be available.

Why is this so Important?

Having your medical information in one place helps you and your providers understand your health better so you can make better choices and help improve your health outcomes.

Keeping Your Protected Health Information (PHI) Safe is Important to Us

The new rule lets you look up your information by using an app from a third party application developer (a company that has no link to California Health & Wellness). We will give you information to think about such as:

  • Choosing an app
  • Ways your data can be used by the third party
  • Why it's important to know the app security and privacy rules

We will also give you information on the Federal Agencies you can contact if you feel your rights to patient privacy have not been maintained.

The CARIN alliance is a two party, multi sector collective. It works to advance consumer led exchange of health information. Learn more on the CARIN Alliance website. The CARIN Code of Conduct is a set of industry practices that are meant to protect your health information.

We will require third-party application developers to certify that they follow the CARIN Code of Conduct. Visit My Health Application for a list of apps that have agreed to the CARIN Code of Conduct.

What can I do now if I want to use an app to share my health information with others?

Find an app. Visit My Health Application for a list of apps that have agreed to the CARIN Code of Conduct.

Download the app. Smartphone apps are available through the Google Play Store (Android) and the App Store (iOS), and web apps are available for computers.  Please read the terms of use, Notice of Privacy Practices and other terms that apply to the app very closely before downloading or using the app.

Create your account. Follow the instructions in the app of your choice to sign up and link your health information.

Use your information to manage your healthcare. Now you have the information you need to make the best health care choices for yourself.

Check out the Frequently Asked Questions or call California Health & Wellness toll-free at 877-658-0305 (TTY 711).  You can reach us Monday - Friday 8:00 a.m. to 5:00 p.m.

Call California Health & Wellness toll-free at 877-658-0305 (TTY 711) Monday - Friday 8:00 a.m. to 5:00 p.m. Or, visit California Health & Wellness.

For more information on CMS Policies and Technology for Interoperability and Burden Reduction visit the CMS website.

How many years back will my information go?

Any health information maintained by the Health Plan with a date of service January 1, 2016 or later will be made available.

What happens to my health information if I go to a different health plan or provider?

You will have access to your health information, no matter what health plan or provider you go to.

Can I find out if I'm up to date on my vaccines?

Yes, some apps may allow you to see what shots you've had with a date of service January 1, 2016 or later.

Do I have to use an app from California Health & Wellness?

No, the app you use will not be linked with California Health & Wellness. You may also visit My Health Application for a list of apps that have agreed to the CARIN Code of Conduct. Follow the instructions on the app to connect it with your health record.

When will I have access to my health care information through the app?

Starting July 1, 2021, you will be able to access your California Health & Wellness information through the apps.

I don't like using an app to get my health care info. Do I have to?

No, you do not have to use an app to access your health care info. You can contact your provider or health plan for needed information.

What health data might the app collect?

The app might collect your health data that includes your:

  • Claims
  • Medications
  • Diagnoses
  • Procedures
  • Doctor visits

Please read the app's terms of use very closely to find out what information the app collects. When you enroll in the app, you are giving your consent for the app to collect that information.

Will the app collect non-health data from my device, such as my location?

Apps are able to collect non-health data such as location. Some apps let you have the option to provide that information. We suggest that you ask your app provider.

What impact would sharing my data with this app have on others, such as my family members?

Asking for your health data via an app might include the health data of family members who are linked with your health account.

How do I correct mistakes in my health data?

To correct mistakes in your health data, you will need to contact your provider or health plan. The health app only makes data available from health care sources.

What are my rights under the Health Insurance Portability and Accountability Act (HIPAA)?

We recommend that you ask the app provider for their notice of privacy and security practices.

Most apps will not be covered by HIPAA. Most apps will instead fall under the jurisdiction of the Federal Trade Commission (FTC) and the protections given by the FTC Act. The FTC Act, among other things, protects against deceptive acts (e.g., an app that shares private data without consent, despite having a privacy policy that says it will not do so). Additionally, for California residents only, Personally Identifiable Information (PII) data is governed and secured under both the California Medical Information Act (CMIA) and the California Consumer Privacy Act (CCPA). Please make sure these acts are mentioned in the copy of the Privacy Notice of your chosen API provider.

The FTC provides information about mobile app privacy and security for consumers on the FTC consumer information website.

For apps that are subject to HIPAA, you can find more information about patient rights under HIPAA and who is required to follow HIPAA.

You can also see the HIPAA FAQs for Individuals.

What are my rights when it comes to my data gathered on this app?

We suggest that you request a copy of the Privacy Notice from the app provider to understand your rights.

What should I do if my data has been shared or stolen, or an app that has used my data in a wrongful way?

We suggest that you request a copy of the Privacy Notice from the app provider. This will help you to understand how they respond to a privacy and security incident. You have the right to file a complaint with enforcement agencies that include the Office for Civil Rights (OCR) and the Federal Trade Commission (FTC).

Learn more about filing a complaint with OCR under HIPAA.

Individuals can file a complaint with OCR using the OCR complaint portal.

Individuals can file a complaint with the FTC using the FTC complaint assistant.

California Residents: Please click on the links listed below for more privacy protections and safeguards concerning data for people living within the state of California.

California Medical Information Act (CMIA)

California Consumer Privacy Act (CCPA)

How will the app use my data?

Please request a copy of the Privacy Notice to understand how the app will use your data.

Can the app share my data with third parties?

We suggest that you request a copy of the Privacy Notice from the app provider. This will help you to understand if the app will share your data with third parties.

If I no longer want to use this app, or if I no longer want this app to have access to my health information, how do I stop the app's access to my data? Do I have to do more than just delete the app from my device?

We suggest that you request a copy of the Privacy Notice from the app provider. This will help you to understand what happens to your data after you stop using the app.

What is the app's policy for deleting my data once I stop using it?

We suggest that you request a copy of the Privacy Notice from the app provider. This will help you to understand what happens to your data after you stop using the app.

What is the process I have to go through to stop sharing data?

One way you may be able to stop sharing data is through the app. Or, by contacting the app provider support. If you can't stop sharing data through the app, or using the app provider support, then you may call California Health & Wellness member services for help toll-free at 877-658-0305 (TTY 711) Monday - Friday 8:00 a.m. to 5:00 p.m.

Will this app sell my data for any reason, such as advertising or research?

We suggest that you request a copy of the Privacy Notice from the app provider. This will help you to understand if the app will share your data with third parties for advertising and research.

How does this app deal with collecting and responding to user complaints?

App providers may respond to user complaints in different ways. We suggest that you ask this question to your app provider.

Will my data be stored in a way that is anonymous?

We recommend that you request a copy of the Privacy Notice from the app provider. This will help you to understand how the app stores your data.

What security measures does this app use to protect my data? Will they inform me if an incident occurs?

We suggest that you request a copy of the Privacy Notice and more information on security practices from the app provider. This will help you to understand how they handle a security incident.

How can I limit this app's use and release of my data?

We suggest that you request a copy of the Privacy Notice from the app provider. This will help you to understand how you can limit the use and release of your data.