More on Policy and Legislation

American Medical Association urges more time for detailed feedback on ONC, CMS information blocking rules

Moving too quickly could lead to unintended consequences that could negatively impact patient privacy, physician burden, the AMA said.

Beth Jones Sanborn, Managing Editor

The American Medical Association is urging ONC National Coordinator Donald Rucker and Centers for Medicare and Medicaid Services Administrator Seema Verma to extend the comment period for 30 days for the recently laid-out proposed federal rules regarding interoperability and information blocking to allow stakeholders to submit the most comprehensive and detailed feedback possible for the complex new rules.

In a letter to CMS Administrator Seema Verma and ONC National Coordinator for Health Information Technology Donald Rucker, American Medical Association CEO Dr. James Madara  wrote that while the 21st Century Cures Act contains provisions that, with regulation, will advance patients' and physicians' access to medical information, change that happens too quickly could lead to unintended consequences for patient privacy and physician burden.

He called the proposed rules "interwoven, complex in nature" said they include multiple detailed requests for information. He said that for stakeholders to provide the necessary detail in their comments, more time was necessary.

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In February, the ONC unveiled its proposed information blocking rule, designed to enable information sharing for patients moving between providers and health insurance plans.

As part of the new rules, CMS will require that healthcare providers and plans put in place open data sharing technologies to enable easier care transitions when patients move between these plan types. As an example, records must be able to be transferred between providers when a patient requests it when they are changing physicians.

What's more, health information exchanges and networks are subject to major fines, as high as $1 million, for lack of interoperability. While providers would not be subject to such fines, CMS said they could impose certain "disincentives."

The ONC has included in the conditions of certification that healthcare IT developers need to publish application programming interfaces (APIs) without special effort and calls on the healthcare industry to adopt standardized APIs in order to help individuals access structured and unstructured EHI formats using smartphones and other mobile devices.

It also implements the information blocking provisions of the 21st Century Cures Act, including defining activities that do not constitute information blocking.

The ONC and CMS worked together on the proposed rules to align their policies and move interoperability forward. The 2020 rule applies to Medicaid, CHIP, Medicare Advantage plans and plans that are part of the ACA federal exchanges.


"Expediency should not take precedence over deliberation as we confront a true paradigm shift in health care. I, therefore, urge that the comment periods for both rules be extended by at least 30 days. I appreciate your consideration and ongoing collaboration."

Twitter: @BethJSanborn
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