CHA News Article

Proposed Rules Issued on Interoperability and Information Blocking

The Department of Health and Human Services has issued two proposed rules – one from the Centers for Medicare & Medicaid Services (CMS) and the other from the Office of the National Coordinator for Health Information Technology (ONC) –  intended to improve the interoperability of health information.

The proposed rules include provisions for hospitals and other providers, health plans and health information technology (HIT) vendors.

The CMS-proposed rule includes a number of significant proposals for hospitals, including a change to the Medicare conditions of participation (CoPs) that would require hospitals — including psychiatric and critical access hospitals — to send electronic notifications when a patient is admitted, discharged, or transferred. CMS also proposes to publicly report the names of clinicians and hospitals who submit a “no” response to the attestations related to information blocking under the Promoting Interoperability programs. In addition — as required by the 21st Century Cures Act — the ONC-proposed rule identifies seven proposed exceptions to information blocking.

The CMS-proposed rule would also require certain health insurers — including Medicare Advantage organizations, state Medicaid and Children’s Health Insurance Program fee-for-service programs, Medicaid managed care plans, and Affordable Care Act plans on federally funded exchanges — to make patient claims and other health information available to patients through third-party applications and developers. CMS would also require these payers to participate in trusted exchange frameworks that allow for participation in any health information network to facilitate national health information exchange.

ONC proposes changes to the 2015 edition health IT certification criteria to promote the adoption of standardized application programming interfaces, specifically requiring the use of Health Level 7 Fast Healthcare Interoperability Resources standards.

The proposed rules also include a number of requests for information, including one that seeks feedback on how the agency can leverage its authority to address patient matching issues. CMS also requests input on how it can promote wide adoption of interoperable health IT systems for use across long-term, post-acute care and behavioral health settings. Finally, the ONC proposed rule seeks feedback on the definition of electronic health information and the implications of including price information within the scope of that definition.

CHA is currently reviewing the proposed rules and will provide members with a more detailed summary in the coming weeks. Additional information is available on a CMS fact sheet and ONC resource page. Comments on the proposed rules are due May 3.

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