Public APIs (Application Programming Interface)
This page lists Wisconsin Medicaid's API endpoints which are available publicly to any 3rd party application. There is no additional authorization required to gain access to these APIs.

The 21st Century Cures Act and the CMS Patient Access API

In December 2016, a bill called the 21st Century Cures Act was signed into law, with several important goals, including improved interoperability between health information systems, and increased patient access to their own health data. This law also empowered the Centers for Medicare & Medicaid Services to create regulations to further this goal, which it did with the creation of the CMS Interoperability and Patient Access final rule (CMS-9115-F). In order to increase patients' access to their health data, the rule prohibits information blocking and requires health insurance plans to give members access and the ability to share their health plan data via an API endpoint with third-party applications of their choice. The mandate also requires health plans to provide 3rd party applications a way to access provider directory information via an API.

What is an API?

API stands for Application Programming Interface. An API allows a way for two systems, such as a 3rd party application and Wisconsin Medicaid's data server, to talk to each other via a standardized, secure handshake. APIs underpin the majority of data exchange and traffic on the Internet.

Provider Directory API

The Provider Directory API is a way for 3rd party applications to access a listing of Wisconsin Medicaid's network of available providers. Clicking on the link directly will open a web page containing the data in JSON (JavaScript Object Notation) format, which is a text-based way to show structured data in a standardized format. This format is not as readable or sortable to an end-user so a 3rd party application should be used to access the data via this API. The 3rd party application can display the information in a way that is easier for a user to understand, and enable searching across the contents.
You can find a list of potential 3rd party applications here.