… a patient's health history. [ 3 4 5 ] This siloed nature of health care data prevents physicians, pharmaceutical companies, manufacturers, and payers from accessing and interpreting important data sets, instead, encouraging each group to make decisions based upon a part of the i…

…quirements of § 457.1233(d) . [ 66 FR 2683 , Jan. 11, 2001, as amended at 85 FR 25635 , May 1, 2020; 88 FR 60315 , Aug. 31, 2023; 89 FR 8982 , Feb. 8, 2024] § 457.710 State plan requirements: Strategic objectives and performance goals. ( a ) Plan description. A State plan must in…

… under § 438.6(d) . ( ii ) State-developed one time payments, for specific life events of enrollees. ( iii ) Other payments to the MCO, PIHP, or PAHP approved under § 438.6(b)(3) . ( iv ) Unpaid cost-sharing amounts that the MCO, PIHP, or PAHP could have collected from enrollees …

… [Reserved] ( c ) This section is applicable beginning January 1, 2021. [ 85 FR 25635 , May 1, 2020] § 431.80 Prior authorization requirements. ( a ) Communicating a reason for denial. Beginning January 1, 2026, if the State denies a prior authorization request (excluding a reque…