ED Coding & Reimbursement Alert - 2019 Issue 5
Interoperability: Twin Proposals Address Health Data-Sharing Flaws
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Article Overview
This article reviews parallel CMS and ONC proposals aimed at improving health information exchange and interoperability across the healthcare system. It explains the broad policy areas addressed, including patient access, payer and provider data sharing, electronic notifications, information blocking concerns, and requests for public comment. The piece is relevant to healthcare compliance, hospital administration, payer operations, and stakeholders tracking federal health IT policy and Medicare/Medicaid program changes.
Why This Topic Matters
The proposals discussed in the article may affect how health plans, hospitals, and other providers share patient information and meet federal interoperability and compliance expectations. Readers working in compliance, revenue cycle, health IT, or policy can use the article to understand the scope of the proposed changes and the kinds of organizations likely to be impacted.
Article Sections
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Context and overlapping CMS/ONC proposals
Introduces the two federal proposals and explains how they relate to broader health IT and information exchange policy efforts.
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CMS patient-centered policy ideas
Summarizes CMS’s general goals for improving patient access to health information and making data more portable across care settings and plans.
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Payer-based APIs beyond Blue Button 2.0
Covers the proposal’s payer-focused interoperability framework, affected plan types, and related exchange and directory topics.
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Policies to punish information blockers
Describes proposed oversight related to data sharing, attestation, and other compliance-oriented measures for providers and hospitals.
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Interoperability requirements in CoPs
Explains the proposed integration of interoperability-related expectations into hospital and critical access hospital participation requirements.
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Models and RFIs
Summarizes CMS’s request for public input on future model testing and on broader health IT adoption and identity protection topics.
What You Will Learn
- The scope of the CMS and ONC interoperability proposals
- Which types of organizations are mentioned as potentially affected
- The major policy areas covered by the proposed rules
- How the article frames patient access, notifications, and data exchange
- What kinds of public input CMS is seeking before regulatory action
Who Should Read This
- Health information management professionals
- Hospital compliance staff
- Payer operations teams
- Health IT stakeholders
- Healthcare policy analysts
- Revenue cycle and reimbursement professionals
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