On November 1, 2023 the Center for Medicare and Medicaid Services (CMS) released a Notice of Proposed Rulemaking (NPRM) on the Establishment of Disincentives for Health Care Providers That Have Committed Information Blocking based on requirements in the 21st Century Cures Act.If finalized, these new rules will allow the HHS Office of Inspector General (OIG) to enforce with disincentives and penalties the Information Blocking rules previously released and in place for nearly a year. The idea of all this is to incentivize the appropriate flow of health information and disincentivize actions that are considered to inappropriately block this flow of information. While any person or organization can raise a claim of information blocking, in his keynote address at the 2023 Sequoia Project Annual Meeting, Micky Trapathi, the National Coordinator for Health Information Technology, ONC does get a steady stream of complaints almost entirely from consumers (as opposed to other organizations).
From a public health standpoint, information blocking is just not that big a deal. Many jurisdictions have existing laws, regulations, or policies that govern public health reporting. HIPAA itself has a public health exclusion that permits data exchange for public health purposes without patient consent. So why should public health care about information blocking? Public health can only benefit from an appropriate, unobstructed flow of information. Much of the infrastructure public health agencies use to enable interoperability with clinical care is built on existing clinical care standards, terminology, and technology. The more that these capabilities are exercised unimpeded, the easier it will be for public health to leverage these capabilities for its own use.
Comments on this NPRM can be submitted to CMS through January 2, 2024.
See the letter of support from Pew Charitable Trusts drafted with our input.