The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) have each released a proposed rule regulating information blocking. Information blocking occurs when a person, such as a health care provider or electronic health record vendor, knowingly and unreasonably interferes with the exchange and use of electronic health information, which is protected under the Health Insurance Portability and Accountability Act (HIPAA).
The ONC proposed rule provides penalties and fines for information blocking, while providing certain exceptions for providers and health IT companies. The rule would allow patients access to electronic health information, available at no cost to the patient. Stakeholders that violate the rule, should it be finalized, could be penalized $1 million per instance of information blocking. The CMS rule proposes that Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Qualified Health Plans be required to make enrollee data available by 2020. The CMS proposed rule also provides that government health plans implement a specific application programming interface (API) to open up data access to third party applications and developers. In addition, the proposed rule includes a provision to publicly list providers who engage in data blocking.
If these proposed rules are passed, health care providers and health care IT companies particularly, would be impacted.