CMS and ONC Release Proposed Rules Focused on Information Blocking and Interoperability

On Monday, February 11, 2019, both the Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) released complementary proposed rules aimed at improving interoperability of and patient access to electronic health information. 

The CMS proposed rule focuses on expanding patient access to medical claims and health records in an effort to help patients make informed health care decisions. CMS proposes to require Medicare Advantage organizations, Medicaid Managed care plans, CHIP managed care entities and Qualified Health Plans in the federally-facilitated Exchanges to provide enrollees with convenient and timely electronic access to their health information. Additionally, CMS is proposing that the Conditions of Participation for Hospitals and Critical Access Hospitals (CAH) be updated to require Medicare-participating hospitals and CAHs to send electronic patient event notifications to other providers and facilities when a patient is admitted, transferred or discharged. For additional information, review the CMS Fact Sheet. 

ONC’s proposed rule focuses on implementing provisions of the 21st Century Cures Act. With information blocking named as a top priority of the proposed rule, ONC seeks to further define stakeholders regulated by the information blocking proposals and identifies seven “reasonable and necessary” activities that do not constitute information blocking. The proposed information blocking exceptions include:

• Preventing Harm
• Promoting the Privacy of Electronic Health Information
• Promoting the Security of Electronic Health Information
• Recovering Costs Reasonably Incurred
• Responding to Requests that are Infeasible
• Licensing of Interoperability Elements on Reasonable and Non-discriminatory Terms
• Maintaining and Improving Health IT Performance

ONC also includes proposals updating its certification criteria for Application Programming Interfaces (APIs), updates to the 2015 Edition Certification Criteria and Conditions and Maintenance of Certification and proposals for certification of health IT used by pediatric health providers. For more information, review the accompanying ONC Press Release from Don Rucker, the National Coordinator for Health Information Technology. 

ASA physicians and staff are currently reviewing the proposed rules and their potential impact on physician anesthesiologists. ASA plans to submit comments on both rules. Comments on these rules will be accepted by CMS and ONC through early April 2019.

For more information, contact the ASA Department of Quality and Regulatory Affairs at [email protected] or 202/289-2222.