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CMS and ONC Proposed Rules Focus on Health IT Interoperability and Preventing Data Blocking

As we alerted you earlier this week, CMS and the Office of the National Coordinator for Health IT (ONC) simultaneously released two proposed rules aimed at improving the exchange of electronic health information (EHI) through improved interoperability of health IT products, including EHRs, and preventing data blocking. The proposed rules implement some provisions of the 21st Century Cures Act passed in late 2016, however, they also seek to fulfill the administration’s goals of providing patients with full access to their digital health records to help them make value-based decisions about their health care. The policies are divided into two proposed rules, so each agency can propose policies under its jurisdiction.

The CMS proposed rule focuses on requiring MA plans, Medicaid plans, and plans available on the federal exchanges to provide their beneficiaries with electronic access to their health data and make their provider networks available electronically. Plans must make this data available through applications programming interfaces (APIs) for third party applications, such as mobile apps, to access at the patient’s direction. In addition, CMS proposes to make publicly available through the Physician Compare website the names of any physician or healthcare provider who it determines engages in data blocking based on attestation as part of the Promoting Interoperability category of MIPS.

The ONC rule proposes updates to health IT certification standards to improve interoperability and reduce data blocking. Specifically, EHR vendors as part of their certification, will be required to make a patient’s full EHI downloadable and electronically exchanged through APIs. ONC notes that it thinks this function will also be useful to physician practices that want to switch EHR systems, as many physicians report difficulty extracting patient data from their EHR because the vendor wants to prevent losing customers.

ASCRS•ASOA will continue reviewing the proposed rules and will be submitting comments. CMS and ONC also released factsheets along with the proposed rules. We will keep you updated.

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