HHS Interoperability Proposal Would Name-and-Shame Info Blockers

The government's plan would put pressure on hospitals and other providers that engage in 'information blocking.'

A highly anticipated proposed rule released Monday morning by the Trump administration would require health plans to begin giving patients immediate electronic access to their medical claims and health information, at no cost, by next year.

Hospitals and other providers that engage in "information blocking"—i.e., limiting the availability of information in ways the government deems unreasonable—would be publicly reported in an effort to pressure them into changing their ways, according to a Health and Human Services announcement.

"We are going to expose the bad actors who are purposely trying to keep patients from their own data," Centers for Medicare and Medicaid Services Administrator Seema Verma said during a press call Monday morning.

The announcement comes on the first day of the Healthcare Information and Management Systems Society (HIMSS) conference in Orlando, Florida, where Verma is scheduled to speak Tuesday on interoperability and patient engagement.

Requiring insurers to share information in an accessible format by 2020 will ensure that 125 million beneficiaries have electronic access to their claims data, Verma said in Monday's announcement.

"This unprecedented step toward a healthcare future where patients are able to obtain and share their health data, securely and privately, with just a few clicks, is just the beginning of a digital data revolution that truly empowers American patients," Verma said.

This change will help beneficiaries make informed decisions about when and where they seek care, HHS Secretary Alex Azar said in the statement.

"These proposed rules strive to bring the nation's healthcare system one step closer to a point where patients and clinicians have the access they need to all of a patient's health information, helping them in making better choices about care and treatment," Azar said.

"These steps forward for health IT are essential to building a healthcare system that pays for value rather than procedures, especially through empowering patients as consumers," he added.

The proposed rule, which was issued Monday by CMS and the Office of the National Coordinator for Health Information Technology (ONC), would apply to Medicaid, the Children's Health Insurance Program (CHIP), Medicare Advantage plans, and plans on the federally facilitated Affordable Care Act exchanges.

Comments on the proposed rule and two related requests for information will be accepted until early April. More information is available in a CMS fact sheet and the proposed rule itself.

Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.