The Department of Health and Human Services (HHS) agencies, including the Office of the National Coordinator for Health Information Technology (ONC), the Centers for Medicare & Medicaid Services (CMS), the Office of Inspector General (OIG) released the 21st Century Cures Act: Establishment of Disincentives for Health Care Providers That Have Committed Information Blocking (Disincentives Final Rule). Information blocking by healthcare providers is when they engage in practices they knew were unreasonable and likely to interfere with, prevent, or materially discourage the access, exchange, or use of electronic health information (EHI), except as required by law or covered by a regulatory exception. This final rule establishes disincentives for Medicare-enrolled providers determined by the OIG to have engaged in information blocking. Specifically, under the Medicare Promoting Interoperability Program, hospitals found to have committed information blocking would no longer be a meaningful user, so they would not receive the program’s positive payment adjustment. Critical Access Hospitals would have their payments reduced from 101% to 100% of reasonable costs, while clinicians in Medicare’s Merit-based Incentive Payment System (MIPS) would receive a score of zero in the MIPS Promoting Interoperability performance category. Under the Medicare Shared Savings Program (SSP), accountable care organizations (ACOs) or providers participating in the ACO that commit information blocking may be ineligible to participate in SSP for at least one year and may not receive revenue they may have earned through the program. ONC and CMS released a fact sheet and Frequently Asked Questions which provide an overview of select provisions of the final rule.
