New Proposals Directed at Interoperability and Access to Healthcare Data

By Featured article

In mid-February, both the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) coordinated the release of complementary proposed rules focusing on increasing patient and provider access to health records.
The proposed rules will “support seamless and secure access, exchange and use of electronic health information,” according to a press release distributed by the U.S. Department of Health and Human Services (HHS).

In general, CMS is proposing that providers and entities who receive government reimbursements (under programs like Medicare Advantage, Medicaid or CHIP, as a few examples) must provide enrollees with immediate electronic access to medical claims and other health information electronically by 2020.

CMS also proposes that claims data be linked with patient records, this will allow providers to review the entire plan of care which would hopefully prevent duplication of tests and/or imaging studies – sometimes considered redundant procedures.

Health systems will also be required to share data and notify providers when a patient is admitted, transferred or discharged from their facilities.

In addition to the secure and more immediate access to health information, the proposed rule under ONC addresses technology. For example, access to information from smartphones and calling on the healthcare industry to adopt standardized application programming interfaces (APIs), which will help data flow back and forth between disparate systems.

The ONC rule also proposed curtailing “information blocking” so organizations cannot prevent or restrict sharing of patient information. For example, requiring a patient to pay a fee to access copies of his health information or limited sharing with other healthcare providers. Information blocking can apply to vendors, providers or institutions. The CMS proposed rule included language that added questions on MIPS attestation specifically referencing practice information blocking.

Practices should look to their specialty societies to understand their position and how it might relate to your practice.

The comment period for both rules is expected to close 60 days after the rules’ publication in the Federal Register, approximately mid-April 2019.
This information was taken from an InfoDive webinar Accounts Receivable, February 2019.