- The American Hospital Association (AHA) recently expressed disapproval for a policy within the CMS Interoperability and Patient Access Proposed Rule that requires hospitals to send admission, discharge, and transfer (ADT) notifications as a condition of participation for Medicare and Medicaid.
The proposed rule is intended to deter information blocking and promote health data exchange across hospitals and providers.
CMS published its proposed rule alongside a proposed rule from ONC that holds health IT developers accountable for information blocking as a condition of health IT certification.
While most stakeholders expressed support for the proposed rules, AHA argued CMS should improve infrastructure to support health data exchange rather than increase requirements for hospitals to participate in Medicare and Medicaid.
“We cannot support including electronic event notification as a condition of participation for Medicare and Medicaid,” stated AHA Senior Vice President for Public Policy Analysis and Development Ashley Thompson. “We believe that CMS already has better levers to ensure the exchange of appropriate health information for patients.”
“We recommend the agency focus on building this exchange infrastructure rather than layering additional requirements on hospitals,” Thompson added.
In addition to including ADT notification use as a condition of participation for Medicare and Medicaid, the proposed rule includes a policy to publicly identify providers and hospitals who engage in information blocking. Eligible providers will need to attest whether they have participated in information blocking to receive full Medicare reimbursement.
The federal agency also plans to require payers to share data with patients. While AHA opposes CMS efforts to add ADT notification use to hospitals’ conditions of participation, the association supports proposed requirements that promote data sharing between payers and patients.
“We believe the proposed requirements on payers to make information such as claims or provider directories available through standard application programming interfaces has the promise to give patients better information about all of their care,” stated Thompson.
Overall, AHA supports the federal agency’s interest in eliminating barriers to health data exchange but recommended CMS avoid imposing additional regulations on hospitals.
“Today, nearly all hospitals and health systems enable patients to view information from their health record online, and each year brings additional gains in sharing across settings of care,” Thompson said. “This increased access to vital health information allows patients to play a more informed, active role in their health and health care.”
“Yet, there are still significant barriers to sharing information,” Thompson continued. “As the administration defines what is not information blocking, we urge them to consider those barriers.”
ONC and CMS released proposed rules on information blocking as part of an effort to fulfill the aims of the 21st Century Cures Act.
In its proposed rule, ONC highlighted the role of the Office of the Inspector General (OIG) in delivering civil money penalties for information blocking. OIG also has the authority to investigate healthcare providers for engaging in information blocking practices.
ONC also offered a list of exceptions to information blocking regulations that help to provide clarity on which practices are considered information blocking and which are not.
Among the seven exceptions to the information blocking rule are practices that promote the security of electronic health information and practices that prevent patient harm. Health IT companies and healthcare organizations are also able to recover reasonable costs to allow for the access, exchange, and use of electronic health information.
The federal agency’s proposed rule also promote the adoption of application programming interfaces (APIs) such as Fast Healthcare Interoperability Resources (FHIR).