HHS Proposes Significant Changes to Patient Access Rules

February 11th, 2019 - Wyn Staheli, Director of Research
Categories:   Medicaid   Medicare   Electronic Medical Records (EMR/EHR)  
0 Votes - Sign in to vote or comment.

In a significant announcement on February 11, 2019, HHS proposed new rules aimed at improving interoperability of electronic health information. This announcement was made in support of the MyHealthEData initiative which was announced by the Trump administration on March 6, 2018. The goal of that initiative was to break down the current barriers faced by patients in obtaining access to their own electronic medical records.

An EHR payment incentive was the first “carrot” CMS dangled to get everyone on board, but that didn’t solve all the problems. Interoperability continues to be a significant roadblock to effective data sharing and access. So last year CMS pulled out a “stick” and implemented rules which allow the use of potential payment reductions for hospitals and clinicians in yet another attempt to encourage healthcare providers to improve patient access to their electronic health information. Admittedly, some of the problem still rests with EHR vendors, so at that time they also issued a Request for Information (RFI) about how to solve some of these outstanding problems.

Some key points in the HHS press release include (emphasis added):

CMS is now 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.

CMS would also require these health care providers and plans to implement open data sharing technologies to support transitions of care as patients move between these plan types.

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 undermine efforts to improve interoperability.

The proposed rule helps ensure that patients can electronically access their electronic health information at no cost.  

Those who would like to may make comments until early April. Although, at the time of publication, the rule had yet to be posted on the Federal Register website, you can follow the information included in the official document for submitting any comments.

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

RT and LT Modifier Usage Change (effective 2019-03-01)
May 21st, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
According to Noridian Medicare, there are new changes required when reporting the RT and LT modifier(s). In the past, it was appropriate to bill the RT and LT modifier on the same line when it was required for certain HCPCS codes. Noridian released a publication stating claims reported with RT/LT on the same ...
Do You Understand Medicare
May 21st, 2019 - Christine Taxin
Even though we may think we truly understand what it means to be a participating provider, Medicare doesn’t quite work the way that other insurance plans do. Far too many providers do not understand the difference and get into hot water. To further complicate matters, the rules are different for ...
An Update on the DHS OIG's Effort to Combat Fraud & Abuse
May 17th, 2019 - Namas
An Update on the DHS OIG's Effort to Combat Fraud & Abuse Every year, the Department of Health and Human Services (DHS) Office of Inspector General (OIG) is required by law to release a report detailing the amounts deposited and appropriated to the Medicare Trust Fund, and the source of such ...
Prioritize Your Patient's Financial Experience
May 13th, 2019 - Wyn Staheli, Director of Research
For many years, the ChiroCode DeskBook has emphasized the need for providers to firmly establish the patient’s financial responsibility through clear communication. We even created a “Patient Financial Responsibility Acknowledgment Form” to help providers with this process. Lately, the lack of pricing transparency has been in the news and even ...
Q/A: Two Payers Both Paid the Claim. Who Gets the Refund?
May 13th, 2019 - Wyn Staheli, Director of Research
Question We have a personal injury situation where we submitted a claim was sent to the patient's auto policy carrier who refused payment. We then submitted it to her other insurance. Eventually, both companies paid her claims. Her auto paid at full value, and her secondary paid at a reduced rate ...
HIPAA Violation Penalties Revised
May 6th, 2019 - Wyn Staheli, Director of Research
On April 30, 2019 The Department of Health and Human Services (HHS) announced that “HHS will apply a different cumulative annual CMP limit for each of the four penalties tiers in the HITECH Act.” Unlike other notices which require a proposed rule with a comment period, this notice will take ...
Q/A: If Orthopedic Tests are Negative, do You List Them in Your Treatment Notes?
May 6th, 2019 - Wyn Staheli, Director of Research
Question: If orthopedic tests are negative, do you need to still list them in your treatment notes? Answer: Yes. Any tests which are performed by a healthcare provider, regardless of the result, should be documented in the patient record. This record is the only way that a reviewer or another provider ...



About Codapedia & Find-A-Code Contact Us Terms of Use Privacy Policy Advertise with Us

Codapedia™/Find-A-Code™ - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain) - Fax (801) 770-4428

Copyright © 2009-2019 Find A Code, LLC - CPT® copyright American Medical Association