Compliance Today (May 2020)
The U.S. Department of Health and Human Services (HHS) announced in a March 9, 2020, news release that it had “finalized two transformative rules that will give patients unprecedented safe, secure access to their health data. Interoperability has been pursued by multiple administrations and numerous laws, and today, these rules finally deliver on giving patients true access to their healthcare data to make informed healthcare decisions and better manage their care.”[1]
HHS Office of the National Coordinator for Health Information Technology (ONC)[2] and Centers for Medicare & Medicaid Services (CMS)[3] issued the two rules that implement interoperability and patient access provisions of the bipartisan 21st Century Cures Act (Cures Act), notes the HHS news release.
Further outlined in the government news release, “The ONC Final Rule identifies and finalizes the reasonable and necessary activities that do not constitute information blocking while establishing new rules to prevent ‘information blocking’ practices (e.g., anti-competitive behaviors) by healthcare providers, developers of certified health IT, health information exchanges, and health information networks as required by the Cures Act.”
“The ONC final rule updates certification requirements for health IT developers and establishes new provisions to ensure that providers using certified health IT have the ability to communicate about health IT usability, user experience, interoperability, and security including (with limitations) screenshots and video, which are critical forms of visual communication for such issues,” per the announcement.
In addition, the ONC final rule “requires electronic health records to provide the clinical data necessary, including core data classes and elements, to promote new business models of care.”
Interoperability
The announcement notes that ONC’s final rule establishes application programming interface (API) requirements meant to support a patient’s access and control of their electronic health information.
The CMS Interoperability and Patient Access final rule “requires health plans in Medicare Advantage, Medicaid, CHIP, and through the federal Exchanges to share claims data electronically with patients.”
The final rule also “establishes a new Condition of Participation (CoP) for all Medicare and Medicaid participating hospitals, requiring them to send electronic notifications to another healthcare facility or community provider or practitioner when a patient is admitted, discharged, or transferred.” With it, “CMS is requiring states to send enrollee data daily beginning April 1, 2022 for beneficiaries enrolled in both Medicare and Medicaid, improving the coordination of care for this population.”
For more on the ONC final rule: http://bit.ly/39Jpw5p.
For more on the CMS final rule: https://go.cms.gov/2TGX7r3.