Trump admin delays interoperability deadlines amid COVID-19

By | April 22, 2020

Dive Brief:

  • The Trump administration is rolling back select deadlines for the healthcare industry to come into compliance with two sweeping rules prohibiting information blocking and bolstering interoperability, acceding to providers asking for more time as they funnel resources into pandemic response.
  • CMS is pushing back the implementation timeline for providers to share admission, discharge and transfer (ADT) notifications and certain payer interoperability requirements by an additional six months. The Office of the National Coordinator for Health IT will not enforce provider EHR requirements for an additional three months, so compliance with information blocking and associated conditions of certification are required by Nov. 2 this year.
  • The move was widely expected but controversial as the pandemic increases digital delivery of medical care and highlights the need for real-time exchange of data.

Dive Insight:

The Trump administration has poured money into the healthcare system and loosened myriad regulations to free up time and resources as hospitals and doctor’s offices struggle to fight the novel coronavirus. HHS said earlier this year as the pandemic became more serious in the U.S. that it was considering rolling back the upcoming deadlines to come into compliance with the interoperability rules finalized March 9.

“Now more than ever, patients need secure access to their healthcare data,” CMS Administrator Seema Verma said in a statement. “Nevertheless, in a pandemic of this magnitude, flexibility is paramount.”

The deadline for providers to be able to electronically share ADT notifications is now a year after the rules are published in the Federal Register, in spring 2021. The ADT provision was one of the toughest pills for hospitals to swallow, with providers arguing notifying each other when a shared patient moves facilities would add more EHR burden onto already stressed clinicians.

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The CMS rule also requires Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Affordable Care Act exchange plans to provide their collective 125 million patients with free electronic access to their personal health data, including medical claims and encounter information, including cost. Those plans also have to make their provider directories available to current and potential enrollees through standardized application programming interfaces (APIs).

CMS said Tuesday it would not be enforcing those API provisions for an additional six months. Enforcement will now begin July 1, 2021.

All other CMS policies will be enforced on schedule. Plans will have to share certain clinical information with each other at the patient’s request by Jan. 1, 2022, and CMS still plans to publicly report actors found information blocking starting later this year.

ONC’s rule standardizes APIs and updates the 2015 Edition certification EHR criteria to ensure IT systems send and receive data in a synchronous manner, while allowing patients to export and view their medical information. The deadlines for the private sector to implement those APIs are the same but compliance won’t be enforced for an additional three months in most cases.

A coordinated public-private sector response to the national health emergency has been largely out of reach, partially due to a lack of health IT infrastructure. Fully interoperable software systems in hospitals, commercial labs, state governments and other key players would be a major step toward a holistic picture of the pandemic, which has infected almost 820,000 people in the U.S. and killed 44,000 as of Tuesday.

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Many health IT experts called for more urgency, not less. The rules require payers and providers to adopt standardized application programming interfaces, which would help clinicians coordinate care, help patients remotely access their medical records and enable physicians to directly report COVID-19 data to public health registries, Ben Moscovitch, health IT project director at the Pew Charitable Trusts, wrote to HHS on April 2.

“Any further delay in this timeline impedes critical benefits to patients,” Moscovitch said.

The HHS Office of the Inspector General on Tuesday also released a proposed rule to enact civil monetary penalties for any actors found information blocking. The rule, if finalized, authorizes HHS to impose the penalties and would increase the maximum penalty for certain violations.

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