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HHS Announced Patient Access Proposal

Compliance Basics
in Compliance Basics

HHS Announced Patient Access Proposal

The Interoperability and Patient Access Proposed Rule outlines opportunities for patient data to be more transferable through open, secure and standardized formats while “reducing restrictive burdens on healthcare providers.” Some of the significant proposed items that may impact providers are:

Improving the Dual Eligible Experience by Increasing Frequency of Federal-State Data Exchanges

CMS proposes an update on the frequency with which states are required to exchange certain Medicare/Medicaid data on dually eligible beneficiaries from a monthly exchange to a daily exchange to improve benefit coordination for the dual eligible population.

This would greatly reduce provider billing mistakes for QMB beneficiaries by having real time status information.

Provider Digital Contact Information

Electronic addresses allow providers to exchange data faster while improving interoperability and could eliminate the need for fax machines for the exchange of health information. A centralized directory of provider electronic addresses for data exchange could ensure the flow of patient information and any needed provider-to-provider communication is seamless for all users. The 21st Century Cures Act required the Secretary to create a provider digital contact information index.

Exchanging data faster would be great, but for those not quite ready to get on board, CMS has proposed a unique type of penalty. The proposed rule states that any providers who do not cooperate and submit digital contact information to their entries in the NPPES system would have their names and NPI numbers reported publicly in the second half of 2020.

Public Reporting and Prevention of Information Blocking

Practices that unreasonably limit the availability, disclosure, and use of electronic health information undermine efforts to improve interoperability.

Once again CMS proposes a public notification process for any providers who have “submitted a ‘no’ response to any of the three attestation statements regarding the prevention of information blocking in the Promoting of Interoperability Programs” (CMS renamed the EHR Incentive Programs to the Promoting of Interoperability in April 2018) The objective is to motivate providers to refrain from information blocking. Additional information can be found online here.

Do not assume because your practice is so small that these changes will not impact you. Take time to look over the proposed rule and submit comments (before April) regarding your concerns. Check out the Fact Sheet provided by CMS here.

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