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The Department of Health and Human Services on Monday released proposed rules to improve the interoperability of electronic healthcare records.

The proposed rules issued by the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT come on the eve of the HIMSS19 conference in Orlando, the largest industry gathering of HIT stakeholders, which kicks off on Tuesday.

Brian M. Kalish/Employee Benefit Adviser

In an unprecedented move, CMS is 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.

“By requiring health insurers to share their information in an accessible, format by 2020, 125 million patients will have access to their health claims information electronically,” said CMS Administrator Seema Verma in a written statement.

For its part, ONC’s proposed rule would implement provisions of the 21st Century Cures Act that deter and penalize “information blocking” by laying out seven proposed exceptions to its definition under the law.

“By supporting secure access of electronic health information and strongly discouraging information blocking, the proposed rule supports the bi-partisan 21st Century Cures Act,” said Don Rucker, MD, National Coordinator for HIT. “The rule would support patients accessing and sharing their electronic health information, while giving them the tools to shop for and coordinate their own healthcare.”

In an effort to shame “bad” actors and incentivize them to refrain from such practices, the 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.

“These proposed rules strive to bring the nation’s healthcare system one step closer to a point where patients and clinicians have the access they need to all of a patient’s health information, helping them in making better choices about care and treatment,” said HHS Secretary Alex Azar in a written statement. “By outlining specific requirements about electronic health information, we will be able to help patients, their caregivers, and providers securely access and share health information.”

Among the far-reaching provisions in the HHS proposed rules are requirements to enable individual patients to securely and easily access their electronic health information using apps on their mobile devices.

Toward that end, HHS is calling on the healthcare industry to “adopt standardized application programming interfaces,” according to the agency’s announcement.

In addition, the proposed rule “would place a strong focus on patient access to their health information through a provision requiring that patients could electronically access their EHI at no cost.”


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