Two health care provider groups, the American Hospital Association and the Medical Group Management Association, have both reacted sharply to the Department of Health and Human Services’ recently issued final rule on information blocking measures.
In separate statements on Monday, the AHA and MGMA said they were “disappointed” that HHS was imposing significant new penalties on covered entities that they determined had interfered with the access, exchange or use of electronic health information.
While both organizations have long said they support information blocking rules governing the interoperability of patient health information, they remain concerned that overly harsh penalties could negatively impact practices, accountable care organizations, and Medicare patients.
WHY IT MATTERS
According to MGMA, medical groups currently face challenges in reporting under the Merit-Based Incentive Payment System, which has 15,000 group medical practice members, ranging from small private clinics to large national health systems employing 350,000 physicians.
“By imposing a zero-point penalty in the Promoting Interoperability category, this rule ensures that violating groups will likely receive a negative payment adjustment for every Medicare claim for the entire payment year,” the Medical Group Management Association said in a statement in response on Monday.
Any vendor found to be engaging in information blocking behavior will be given a zero score for the MIPS Interoperability requirement, which will put their revenue at risk.
“As a result, health care providers may not receive the revenue they could earn through the Savings Share Program,” HHS said in its notice of the final rule.
Some exceptions would allow providers to deny requests for access to EHI without incurring penalties. But understanding them would require significant training for providers, industry experts have said since the proposed rule was released for public comment late last year.
MGMA and AHA have called for education and resources to help providers avoid costly mistakes when dealing with the complexities of exceptions. In April, ONC released a fact sheet to help explain exceptions and previous webinars on information sharing exceptions.
Determining which certified health IT developers and vendors are responsible in an information intercept referral investigation can also create complications for the HHS Office of Inspector General.
However, if the OIG investigation finds that individuals or organizations engaged in information interception, affected providers could face civil penalties of up to $1 million per violation, according to a February statement from the American Medical Association.
“Providers in accountable care organizations who engage in information blocking will be ineligible to participate in the Medicare Savings Sharing program for at least one year and may not receive revenue they would have earned through the program,” the AHA said in a statement today.
According to the Electronic Health Records Association, these narrowly focused roadblocks will do little to support broader interoperability and better access to health information.
“HHS continues to focus this final rule only on certified health IT users, ignoring a significant list of other stakeholders, such as laboratories and providers who do not participate in MIPS but still play a central role in the exchange of health care information,” said Altera Digital Health’s Leigh Burchell, vice president of the EHRA Information Blocking Compliance Task Force.
“A more comprehensive approach to prevention measures could encourage more health care providers to adopt information-sharing best practices.”
She added that both ONC and CMS need to step up their education efforts on the final rule.
“It is clear that the number one obstacle to compliance today is a lack of awareness of the requirements in hospitals and physician offices.”
The final rule takes effect 30 days after publication in the Federal Register on June 24.
THE BIGGER TREND
The deterrents are primarily aimed at providers participating in the CMS program, which some organizations such as the American Academy of Radiology believe is an appropriate mechanism to deter providers.
However, vendors participating in the MIPS and Advancing Interoperability Programs and accountable care organizations have complied with the interoperability requirements of certified EHR technology through CMS program obligations, the Electronic Health Records Association said in comments submitted to the agency.
In January, several organizations, including MGMA and EHRA, released comments to the Office of the National Coordinator for Health Information Technology, the Centers for Medicare & Medicaid Services, and the Office of Inspector General on the proposed federal rule.
They called for a consistent approach to interoperability barriers, as required by the 21st Century Cures Act.
“CMS may consider issuing a restraining order as a negative payment adjustment for the first violation, then providing education and resources on how to comply with information sharing requirements rather than posting that party’s information on a block website,” said the Health Information Management Systems Society, parent company of the Healthcare IT Newssaid in his comments.
ON PROFILE
“HHS could have chosen to work with providers to implement corrective action plans, but instead imposed unnecessary punitive penalties that financially harmed practices and negatively impacted Medicare patients,” MGMA said in a statement.
“AHA is disappointed that HHS chose to ignore most of the comments it received and is deeply concerned that the blocking structure retained in the final rule is excessive, confusing, and unbalanced,” the organization said in a separate statement.
Andrea Fox is senior editor of Healthcare IT News.
Email: [email protected]
Healthcare IT News is a publication of HIMSS Media.
