CMS, ONC Propose New Requirements to Improve Interoperability

The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) proposed new rules to increase interoperability of electronic health care records. These policy changes support the MyHealthEData initiative to improve care coordination.

According to the CMS press release, “The Interoperability and Patient Access Proposed Rule outlines opportunities to make patient data more useful and transferable through open, secure, standardized, and machine-readable formats while reducing restrictive burdens on healthcare providers.”  

The proposed changes would mean that Medicaid, the Children’s Health Insurance Program, Medicare Advance plans, and Qualified Health Plans in the Federally-facilitated Exchanges are required to provide their enrollees with access to electronic medical claims and insurance information by 2020.

New requirements related to application programming interfaces, health information exchanges, and security practices for information blocking are also explained in detail.

“For far too long, electronic health information has been stuck in silos and inaccessible for healthcare consumers,” said CMS Administrator Seema Verma. “Our proposals help break down existing barriers to important data exchange needed to empower patients by giving them access to their health data. Touching all aspects of healthcare, from patients to providers to payers and researchers, our work leverages identified technology and standards to spark new opportunities for industry and researchers while improving healthcare quality for all Americans. We ask that members of the healthcare system join forces to provide patients with safe, secure access to, and control over, their healthcare data.”

With the announcement, CMS also released 2 Requests for Information (RFIs) on interoperability and health information technology adoption in Post-Acute Care settings, as well as the role of patient matching in interoperability and improved patient care. The hope is that these RFIs will continue to open the conversation surrounding improving health care coordination, as well as solicit feedback to CMS on how best to promote interoperability, reduce the burden on clinicians, providers, and patients, and lead change to a value-based health care system.

CMS will accept comments on the proposed rule and the RFIs until early April. Concrete dates will be posted website when confirmed.—Edan Stanley