The CMS Rule requires the implementation of Payer-to-Payer exchange in 2022. PDex includes reference to a $member-match operation that enables a new payer to check with a member/prospective member's prior payer(s). If a unique member is matched the new payer will be able to request the health record from the prior health plan.

The PDex IG will be updated to provide some guidance (but not requirements) on options a payer can take to CONSUME the data from the prior plan.