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Interoperability and Patient Access for Medicaid Members
Starting April 1, 2023, Louisiana Medicaid fee-for-service members have more control and greater access to their health information through their mobile devices. Members can request Medicaid share their medical records with a mobile app of their choosing. It can take up to four weeks from the time of the request for information to be available on the mobile app.
If members choose, they will be able to see their medical claims, test results, and appointments; the cost of care; and their healthcare providers right on their phones. This can be shared through any mobile app currently designed and approved to display Louisiana Medicaid data. Not all apps will display all data available; it is up to the member to select the app that best suits their needs.
Currently, there are three third party apps available to serve Fee-For-Service members: Flexpa, CareEvolution and mPoweredHealth. Visit their websites to learn more about these apps. Check back for additional apps in the future.
This is not to manage your Louisiana Medicaid eligibility and it will not allow you to change your health plan. You will continue to use the MyMedicaid.la.gov website to apply for Medicaid or manage your Medicaid account. You will continue to use your health plan’s website or mobile app for information about your benefits and services through your health plan.
Why would I want to make my data available through a mobile app?
Having easy access to your health information through an app can:
- Give you control of your health information.
- Make it easier to share your health information with healthcare providers, caregivers, or anyone you chose.
- Help you manage and improve your health.
Visit your health plan’s website to see what they are doing about patient access.
- Aetna Better Health
- AmeriHealth Caritas
- Healthy Blue
- Humana Healthy Horizons in Louisiana
- Louisiana Healthcare Connections
- United Healthcare Community Plan
Frequently Asked Questions about Interoperability and Patient Access for Louisiana Medicaid Members
What kind of information will I be able to see through the mobile app?
nitially, for fee-for-service members, you will be able to see claim information that has been billed and processed by Louisiana Medicaid. Eventually, you will also be able to see medical test results, past visits with healthcare providers, and other clinical data that has been processed by Louisiana Medicaid.
You must give your permission for Louisiana Medicaid to share that information with the app of your choosing. Please note, this means the information shared could include sensitive information about mental health conditions, HIV/AIDs, and/or substance use disorders.
Why is this app option available now?
The Centers for Medicare and Medicaid Services (CMS) created a new rule that seeks to give Louisiana Medicaid members more control and easy access to their health information through a mobile app. Click here to read the full rule.
What should I know about the app before I agree to let Louisiana Medicaid or my health plan share my data?
It is very important that you read the privacy policy and terms of use carefully before you choose an app.
The apps you will choose from are third party apps. This means that they are made and controlled by someone other than Louisiana Medicaid, your health plan, or your healthcare providers.
You get to choose which app you want and you will have to give the app permission to access your health and personal information from Louisiana Medicaid, your health plan, and your healthcare providers. This information cannot be shared without your consent. Once consent is provided, the app can access your health and personal information for 90 days before needing you to re-consent.
The apps are not subject to the same patient privacy regulations as Louisiana Medicaid, your health plan, or your healthcare providers, such as the Health Insurance Portability and Accountability Act (HIPAA). Louisiana Medicaid, your health plan, and your healthcare providers are not responsible for your health and personal information once it goes to the app.
Review the mobile app company’s privacy policy before making a decision. This policy will outline how the company will use your health and personal information. Please note there is no law that requires a mobile app to have a privacy policy. It is possible some mobile company apps will not have a privacy policy. If they do have a policy, they are required to follow it.
It is very important you understand the app’s policies and terms before you agree to share your information.
What should I look for in my chosen mobile app’s privacy policy?
The privacy policy should be easy for you to read and understand. Look for a clear explanation of how the app will use your data. If the app does not have a privacy policy, you should not use that app. You can change your choice of app at any time.
When you review the privacy policy for the app, ask yourself these questions to help you make the right selection:
- What health data will this app collect? Will this app collect non-health data from my device, such as my location?
- Will my data be stored in a way that I can be identified?
- How will this app use my data?
- Will this app disclose my data to other third parties?
- Will this app sell my data for any reason, such as advertising or research?
- Will this app share my data for any reason? If so, with whom? For what purpose?
- How can I limit this app’s use and disclosure of my data?
- What security measures does this app use to protect my data?
- What impact could sharing my data with this app have on others, such as my family members?
- How can I access my data and correct incorrect data stored by this app?
- Is there a way to submit complaints or contact customer service?
- 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 end the app’s access to my data?
- What is the app’s policy for deleting my data once I end its access? Do I have to do more than just delete the app from my device?
- How does the app inform users of changes that could affect its privacy practices?
If the app’s privacy policy does not answer these questions for you, you should reconsider using the app to access your health and personal information. Health and personal information is very sensitive, and you should be careful to choose apps with strong privacy and security standards to protect it.
What are my rights under HIPAA?
Your medical and health information is private and should be protected. HIPAA is a federal law that gives you rights over your health information and creates rules on who can look at and receive your health information. 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 must follow HIPAA here and frequently asked questions about HIPAA can be found here.
Most third-party apps will not be covered by HIPAA.
Does HIPAA protect my data once it is sent to the app?
Most third-party apps will not be covered by HIPAA. Instead, most apps will fall under the jurisdiction of the Federal Trade Commission (FTC) and the protections provided by the FTC Act. Under the FTC Act, apps cannot share your personal data without permission or do anything else “deceptive” with your data.
Whenever you download an app to your phone, you are prompted to click “I agree” after being shown an app’s policy statement or terms of use. When you click “I agree” that means you have agreed to that policy or the terms of use, and you are giving that app permission to use your data in whatever way was described in their policy statement or terms of use. This is why it is important to read the policy or terms of use very carefully.
The mobile app’s privacy policy will outline how the company will use your health and personal information. However, there is no law that requires a mobile app to have a privacy policy. It is possible some mobile company apps will not have a privacy policy. If you are not prompted to click “I agree”, that probably means the app does not have a privacy policy. If they do have a policy, they are required to follow it.
What if I think my data has been accessed, shared or used inappropriately?
If you have a concern about the use of your data, you can file a complaint. You can file the complaint with Louisiana Medicaid or your health plan or you can submit a complaint directly to the Office of Civil Rights (OCR) or the Federal Trade Commission (FTC). You can submit to OCR or FTC without contacting Louisiana Medicaid or your health plan. Contacts for all are below.
- Health Plan Members – Call the member services number on your ID card or you can find the member services number at the Healthy Louisiana web site. You can also submit a complaint directly to Louisiana Medicaid.
- Louisiana Medicaid health plan and fee-for-service members – Contact Medicaid by email at MyMedicaid@la.gov.
- Office of Civil Rights:
- 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.
- Federal Trade Commission – Individuals can file a complaint with the FTC using the FTC complaint assistant: https://reportfraud.ftc.gov/#/
I’m not comfortable using an app to get my health and personal information. Do I have to?
No, you do not have to use an app to access your health and personal information. You can contact your healthcare provider or health plan for needed information.
Where can I get more information from my health plan?
What if I am not a member of a health plan but I do have Louisiana Medicaid?
The Louisiana Department of Health is also working to comply with the patient access rule. We anticipate Louisiana Medicaid fee-for-service members will be able to select a mobile app and access the same patient data as health plan members by Summer 2022.
When will I be able to select an app and view my data?
This depends on how you receive your health care services. If you receive your health care services through fee-for-service/Legacy Medicaid, we anticipate you will be able to select an app by Summer 2022. If you receive your health care services from a health plan, click on the name of your health plan below for more information or contact your health plan.