The Sequoia Project Releases TEFCA Flow-Down Resource

The Sequoia Project, selected by ONC as the Recognized Coordinating Entity (RCE) for the Trusted Exchange Framework and Common Agreement (TEFCA), has released a new resource to help healthcare organizations comply with the Common Agreement’s flow-down obligations.

The “Informational Resource for Flowing Down Common Agreement Provisions Into Framework Agreements” (TEFCA Flow-Down Resource) aims to help qualified health information networks (QHINs), participants, and subparticipants in compliance with the Common Agreement’s required flow-down obligations.

Required flow-down provisions ensure that QHINs legally bind TEFCA participants to specific terms and conditions of the Common Agreement. Flow-down requirements also ensure that participants and subparticipants, and subparticipants and downstream subparticipants, are legally bound by these same terms and conditions of the Common Agreement.

The resource is divided into two parts. First, it outlines general information regarding each section of the Common Agreement and its impact (or lack thereof) on Participant-QHIN Agreements.

The second section of the resource gives example terms and requirements that must be flowed down to a QHIN’s participants according to the QHIN’s obligations under the Common Agreement.

The Sequoia Project also released The Types of Entities That Can Be a Participant or Subparticipant in TEFCA Standard Operating Procedure (SOP) Version 1, which the RCE revised based on public feedback.

The document aims to help entities determine the entry point to the TEFCA network that works best for them.

“Providing this type of clarity will be valuable to QHINs, participants, and subparticipants in determining whether or not to sign Framework Agreements to exchange information in TEFCA with different entities,” officials wrote in the SOP.

Suppose an entity is not entitled to request information under one or more of the Exchange Purposes. In that case, it does not qualify as a participant or subparticipant for purposes of any Framework Agreement, according to the SOP.

A participant or a subparticipant can be one or more of the following types of organizations:

• a Covered Entity (or a Business Associate acting on its behalf for the Exchange Purpose of the Covered Entity)
• a Government Healthcare Entity (or an agent or contractor of the Government Healthcare Entity acting on its behalf for the Exchange Purpose of the Government Healthcare Entity)
• a Healthcare Provider (or the Healthcare Provider’s agent or contractor acting on its behalf for the Exchange Purpose of the Healthcare Provider) but not a Covered Entity or a Government Healthcare Entity
• a federal, state, local, or tribal agency, instrumentality, or other unit of government that determines whether an individual qualifies for government benefits for any purpose other than healthcare (for example, Social Security disability benefits) to the extent permitted by Applicable Law (or its agent or contractor acting on its behalf for the Exchange Purpose of such an agency, instrumentality, or other unit)
• a Public Health Authority (or its agent or contractor acting on its behalf for the Exchange Purpose of the Public Health Authority)
• an IAS Provider
• any entity that contracts with and enables connectivity for any of the entities listed above