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February 27, 2019

Our 4 key takeaways from the big new ONC, CMS health IT proposals

Daily Briefing

    By Naomi Levinthal, Practice Manager, Health Care IT Advisor

    Naomi Levinthal

    In the lead up to the HIMSS19 conference a couple of weeks ago, the health IT industry was in a flurry about new proposals recently released by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC). CMS and ONC took advantage of the engaged HIMSS19 audience to share information about the complementary proposed rules, which aim to promote greater interoperability for the healthcare industry and patient access to their health information, and implement key provisions of the 21st Century Cures Act.

    The CMS proposed rule mostly concerns improved access to clinical, encounter, claims, and other types of data that can be shared among patients, plans, and federal agencies. There are some additional policies proposed on how CMS can discourage information blocking, capture more electronic addresses for providers, and require hospitals to electronically send admission, discharge, and transfer notifications.

    The ONC proposed rule primarily impacts health IT developers, as it includes major changes to the certification program that will require updates to their technology, with releases expected to be made available to end users two years after the final rule is issued. The proposed rule also clarifies how the healthcare industry can prevent information blocking among health care providers, health IT developers, exchanges, and health information networks.

    Here are our four key takeaways from the proposals:

    1. Together, these proposals reflect a significant step by both agencies to "crack down" on siloes of patient data and any practices that prohibit access to, and exchange of, information in the healthcare industry. We anticipate when these rules are finalized in later 2019, they will provide a floor from which CMS and ONC will build on to continue to encourage greater interoperability.

    2. The CMS proposal "doubles down" on access to data through Application Programming Interfaces (APIs). It follows and expands on the MyHealthEData initiative, and would require specific types of plans and agencies to provide information to patients and share beneficiary data between plans via APIs. 

    3. The ONC Health IT Certification program will undergo a facelift. Certification criteria are slated to be removed, replaced, revised, or newly added in order to support evolving health IT standards and interoperability. Additionally, ONC will require health IT developers, through their conditions of certification, to meet new business standards including the removal of "gag clauses."

    4. The long-awaited clarifications on information blocking exceptions provide better direction. We field a lot of questions at Advisory Board on compliance around information blocking. We suggest that providers and health IT developers use the public comment period (due May 3rd) to give feedback on the exceptions CMS has outlined, and any other circumstances which may also deserve their own category.

    For more on these proposals, see our newly released less-than-10-minute read on the details.

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