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MACRA's Information Blocking Threat May be Toothless

Analysis  |  By  
   November 22, 2016

Whether the practice of reasonable or unreasonable data blocking yields to government or market forces in 2017 remains to be seen.

As we await stronger signals about where the Trump administration will take health IT from here, keep in mind that the Republican contribution to the MACRA legislation talked tough about information blocking by healthcare providers and HIT vendors.

This tough talk, which originated in Senate hearings in 2014 and 2015, pegged information blocking as a key factor inhibiting the growth of value-based care and was echoed in a 2015 ONC report commissioned by the Republican-controlled Congress as well as ranking committee Democrats in the House and the Senate..

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As a refresher, ONC's report states that information blocking occurs "when persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information."

MACRA spells out just how ONC would enforce its new power to combat information blocking. On or after April 16, healthcare providers will submit attestations to CMS which require the provider to affirm they did not knowingly and unreasonably interfere with the exchange or use of electronic health information.

Following such attestations, providers who feel that information blocking is continuing to occur are free to complain about it to ONC, and CMS is empowered by MACRA to audit these providers. If the audit reveals that the complaint is warranted, CMS is further empowered to take appropriate action.

Comments on this part of the MACRA file rule ranged from concerns that it was too vague to concerns that it was too prescriptive.

"The majority of commenters, whether they supported or opposed the proposal, stressed that certain factors that prevent interoperability and the ability to successfully exchange and use electronic health information are beyond the ability of a healthcare provider to control," CMS wrote in the final rule.


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Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.

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