HHS Proposes Significant Changes to Patient Access Rules

February 11th, 2019 - Wyn Staheli, Director of Research
Categories:   Medicaid   Medicare   Electronic Medical Records (EMR/EHR)  
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In a significant announcement on February 11, 2019, HHS proposed new rules aimed at improving interoperability of electronic health information. This announcement was made in support of the MyHealthEData initiative which was announced by the Trump administration on March 6, 2018. The goal of that initiative was to break down the current barriers faced by patients in obtaining access to their own electronic medical records.

An EHR payment incentive was the first “carrot” CMS dangled to get everyone on board, but that didn’t solve all the problems. Interoperability continues to be a significant roadblock to effective data sharing and access. So last year CMS pulled out a “stick” and implemented rules which allow the use of potential payment reductions for hospitals and clinicians in yet another attempt to encourage healthcare providers to improve patient access to their electronic health information. Admittedly, some of the problem still rests with EHR vendors, so at that time they also issued a Request for Information (RFI) about how to solve some of these outstanding problems.

Some key points in the HHS press release include (emphasis added):

CMS is now proposing requirements that Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Qualified Health Plans in the Federally-facilitated Exchanges must provide enrollees with immediate electronic access to medical claims and other health information electronically by 2020.

CMS would also require these health care providers and plans to implement open data sharing technologies to support transitions of care as patients move between these plan types.

CMS rule also proposes to publicly report providers or hospitals that participate in “information blocking,” practices that unreasonably limit the availability, disclosure, and use of electronic health information undermine efforts to improve interoperability.

The proposed rule helps ensure that patients can electronically access their electronic health information at no cost.  

Those who would like to may make comments until early April. Although, at the time of publication, the rule had yet to be posted on the Federal Register website, you can follow the information included in the official document for submitting any comments.

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