The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) finalized rules March 9th requiring major changes for payers and hospitals to provide patients unprecedented safe access to their own health information. The rules address interoperability, information blocking, patient access to data and electronic health record (EHR) certification. In most cases, compliance calls for implementing significant data transparency requirements.
CMS mandates that hospitals and health systems connect admission, discharge and transfer (ADT) systems ASAP. Within just six months or effective September 9, 2020, providers must electronically send ADT alerts to community providers when patients are seen in the emergency department or admitted to, discharged and/or transferred from the hospital to another community provider or practitioner.
This timeline is aggressive and appropriate. ADT alerts improve care quality and reduce readmissions. Notifications further help primary care providers keep track of patients during public health crises, most notably the COVID-19 (coronavirus) pandemic. Now CMS is requiring these hospitalization alerts as a condition of participation in Medicare and Medicaid.
Additional time-sensitive requirements include:
- Hospitals must start sending ADT notifications to patients’ physicians in a little more than six months. Payers have until the end of the year.
- CMS will start publicly reporting the identity of clinicians, hospitals and critical access hospitals “information blocking” in late 2020.
- Many health plans will need to start sharing claims, cost and health information electronically with patients. Medicaid, the Children’s Health Insurance Program (CHIP), Medicare Advantage (MA) plans and qualified health plans must make enrollee data immediately accessible.
The Los Angeles Network for Enhanced Services (LANES) is prepared to support healthcare providers who administer care to Los Angeles County residents. We are ready to help participants comply with the final rules and implement our HIE date exchange to make protected patient health information more interoperable.
We are offering incentives (including the Cal-HOP grant) to offset costs to payers, hospitals and health systems for participating in the LANES network by June and sharing ADT notifications by September.
Interested organizations can contact:
Brad Hibbard
Vice President of Sales and Marketing, LANES
949.633.3900
For more information on the CMS final rule, visit: Interoperability and Patient Access Fact Sheet.
To view the CMS final rule, visit: CMS Interoperability and Patient Access final rule.
To view the ONC final rule, visit: ONC’s CURES Act Final Rule.
