More organizations are submitting comments to the Office of the National Coordinator for Health Information Technology, Centers for Medicare & Medicaid Services, and Office of the Inspector General on the proposed federal rule to establish disincentives for provider information blocking based on of the 21st Century Cures Act.
Most barriers target providers participating in CMS programs, which some organizations, such as the American College of Radiology, believe is the appropriate mechanism to discourage providers.
The Electronic Health Record Association reiterated that providers currently involved in the Merit-Based Incentive Payment System and the Promoting Interoperability Program and accountable care organizations are already using Certified EHR technology and are likely “substantially” adhering to interoperability standards through their CMS program . obligations.
“Conversely, providers who are exempt from or ineligible for these programs, such as small practices with PI waivers, ambulatory surgical centers, long-term care facilities, and laboratories, are less likely to have access to interoperable technology and are therefore more likely to face challenges that meet the requirements for exchange,” the EHR Association said on December 20 comment letter released this week.
Including information-blocking disincentives in other Centers for Medicare & Medicaid Services Innovation programs could also impact small practices and require additional consideration in the final rule, EHRA noted.
“For providers outside this scope, specific disincentives may be necessary, tailored to each category.”
Also, EHRA said the proposed rule “will do little to convince those who are reluctant to embrace information sharing as a fundamental strategy for their organization,” arguing that “some will find that they are not motivated to change based on the proposed financial impact. .”
Because compliance is based on active participation in a connected health data environment, EHRA suggested that the proposed disincentive rule targeting only CEHRT users “appears to contradict ONC’s previous emphasis that all providers should engage in information sharing , regardless of their use of CEHRT.”
The organization is asking ONC to analyze the complaint-blocking information received to date to determine whether providers fall within the scope of the proposed disincentives.
“The objectives of the program will be jeopardized if an appropriate range of providers does not have sufficient incentives to refrain from blocking information,” EHRA said.
Calls for a finer approach
EHRA also noted that questions from U.S. Health and Human Services researchers to its developer members may have been taken out of context, as they are not always responsible for configuring or monitoring the use of certain certified health IT features within an involved organization.
The organization requested that evidence regarding system configuration and use be “directed to the healthcare organization responsible for those settings.”
Meanwhile, the Health Information Management Systems Society, the parent company of Healthcare IT newsthus in being comment letter It was announced Tuesday that while specific responses to the proposed barriers to information blocking by the hospital, provider and ACO varied among members, it recommends that information blocking regulators take a layered approach.
“CMS could consider issuing the disincentive as a negative payment adjustment for the first violation, and then providing education and resources on how to comply with information sharing requirements instead of blocking the party on the website of information,” says the healthcare technology member organization. said.
HIMSS said the approach would allow providers “acting in good faith to take corrective action and not lose their incentive payments.”
The costs could hurt some health care providers, including doctors
The American Hospital Association called ONC’s information blocking incentives excessive and told the agency it could threaten the financial stability of hospitals that are already economically struggling.
“Using the formula outlined in this scenario, several AHA members estimated what their own penalties could be and concluded that the impact could be more than three times greater than the highest level stated in the range published in the rule, and an average impact that is almost ten times higher than the median cited in the rule,” the hospital association said in its comments.
HIMSS acknowledged a “widespread perception” that succeeding in the MIPS program “costs more than the stimulus payments provide.”
The redundancy of the financial barriers with existing barriers related to failure to meet current PI and MIPS requirements is a concern for other HIMSS members, the organization said.
“Many HIMSS members are concerned that, at a time when there have been significant changes in healthcare regulations, the added layer of complexity and potential cost could push providers out of Medicare incentive programs rather than promoting interoperable information sharing . “
The Medical Group Management Association also said ONC’s proposed rules impose unnecessary financial burdens and would impact the delivery of Medicare and value-based care.
“The substantial administrative burdens and challenges faced by medical groups under the MIPS program will be exacerbated if agencies proceed with this punishment,” MGMA said.
On the other hand, HIMSS, like EHRA, noted that some segments of members fear that penalties for smaller practices “are not significant enough to change information blocking behavior, especially if there was a business case for that actor to participate engage in information blocking.”
However, ACR suggested that CMS use enforcement discretion to “hold harmless” providers for first-time violations, with warnings and compliance support in its policy. comment letter.
Individual physicians rarely have influence over data sharing policies, “thus should rarely be a priority target for information-blocking investigations and disincentives,” ACR argued.
Proposed exceptions to information blocking in ONC’s proposed disincentive rule would require significant training, industry and policy experts say, and for each information blocking reference examined, OIG will need to unravel which developers and suppliers of certified healthcare IT are responsible.
Andrea Fox is editor-in-chief of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.