What You Should Know:
– The U.S. Department of Health and Human Services (HHS) announced a new final rule today aimed at preventing information blocking in healthcare.
– The final rule establishes disincentives for healthcare providers who engage in practices that interfere with a patient’s access to their electronic health information (EHI).
What is Information Blocking?
Information blocking occurs when a healthcare provider knowingly and unreasonably interferes with the access, exchange, or use of a patient’s EHI. This can hinder communication between providers, delay treatment, and ultimately harm patient care.
The New Rule: Disincentives for Blocking Information
The new rule outlines specific disincentives for healthcare providers who are found to have committed information blocking. These disincentives are implemented through existing healthcare programs:
- Medicare Promoting Interoperability Program: Hospitals or critical access hospitals found to be information blocking will not be considered meaningful EHR users, leading to a loss of potential financial rewards.
- Merit-based Incentive Payment System (MIPS): Clinicians who block information will receive a zero score in the Promoting Interoperability performance category, potentially lowering their overall MIPS score and impacting their reimbursement.
- Medicare Shared Savings Program: Accountable Care Organizations (ACOs) found to be blocking information may be excluded from the program for at least a year, forfeiting potential revenue.
Phased Implementation and Potential for Further Action
These disincentives will take effect 30 days after the final rule’s publication, with the exception of the Medicare Shared Savings Program, which won’t be implemented until January 1, 2025. The rule leaves room for additional disincentives to be established in the future.
Complementary OIG Rule
This HHS rule complements an OIG final rule established in June 2023 that addresses information blocking by entities other than healthcare providers, such as health IT developers and information exchanges. Those entities face potential civil monetary penalties of up to $1 million per violation.
A Step Towards a More Connected Healthcare System
By addressing information blocking, HHS aims to improve patient access to their health data and streamline communication between healthcare providers. This final rule represents a significant step towards a more interconnected healthcare system, fostering better-coordinated care and improved patient outcomes.