generated: '2026-07-18'
method: derived
source: openapi/clover-health-fhir-openapi-original.yml + https://www.cloverhealth.com/developers
# Cross-cutting standards the Clover Health public API conforms to.
# Derived from the OpenAPI (FHIR resource paths, media types, search params)
# and the developer portal's stated CMS interoperability posture. Absence of a
# standard is honest data, not a gap to fill.
standards:
  - id: fhir-r4
    conforms: true
    evidence: paths expose FHIR R4 resources (List, MedicationKnowledge, Practitioner, Organization, Location, InsurancePlan, HealthcareService, Endpoint, OrganizationAffiliation, PractitionerRole); media types application/fhir+json and application/fhir+xml
  - id: fhir-us-core
    conforms: true
    evidence: Provider Directory follows the CMS/FHIR US Core provider directory profiles; _profile search parameter supported
  - id: cms-interoperability-9115
    conforms: true
    evidence: Clover Health publishes Provider Directory API and Patient Access API required by the CMS Interoperability and Patient Access final rule (CMS-9115-F); first payer live on a CMS-aligned/TEFCA network
  - id: fhir-bulk-data
    conforms: false
  - id: smart-on-fhir
    conforms: false
    evidence: no /.well-known/smart-configuration published on the public API host
  - id: oauth2
    conforms: false
    evidence: public Formulary/Provider Directory API uses HTTP Basic + session cookie; Patient Access API (CareEvolution) is separately authorized with member consent
  - id: rfc9457-problem-details
    conforms: false
    evidence: FHIR APIs signal errors with an OperationOutcome resource, not application/problem+json
  - id: pagination
    conforms: true
    evidence: FHIR Bundle paging via _count / _offset query parameters and Bundle.link (self/next) navigation
  - id: content-negotiation
    conforms: true
    evidence: Accept-driven negotiation between application/fhir+json and application/fhir+xml