On February 11, 2018, the Centers for Medicare and Medicaid Services (CMS) released the much-anticipated Interoperability and Patient Access Proposed Rule after delays that resulted from the government shut-down. This rule clearly demonstrates that CMS remains very interested in using policy levers to increase patient access to medical information and to increase the frequency of data sharing among providers to more efficiently and effectively coordinate care. The removal of obstacles to achieving nationwide interoperability remains a prominent theme.
Below you will find a summary of the CMS proposed rule and the corresponding areas of impact to various stakeholders within the healthcare community.
Under the CMS proposed rule, health plans and payers will find requirements focused on promoting patient access to their medical data as well as requirements aimed at utilizing technology in the healthcare space.
CMS has also proposed new requirements and model testing in an effort to incentivize the provider, health systems and hospitals to participate in interoperability activities:
In an effort to better coordinate care, CMS has also proposed an update that aims to improve benefit coordination for the dual eligible population by increasing the frequency by which states are required to exchange Medicare and Medicaid data. This proposed frequency has been increased from a monthly exchange to a daily exchange. State Medicaid plans will submit the required Medicare Modernization Act (MMA) file data to CMS every business day.
As with all proposed CMS rulemaking, interested stakeholders will have an opportunity to submit public comments and feedback in response to this proposed rule and the included requests for information. Those wishing to submit comments on the Interoperability and Patient Access proposed rule or to answer specific questions from the RFI will be given a 60 day comment period following the publication of the proposed rule in the Federal Register. Comments may be submitted electronically, to www.regulations.gov, by regular mail, and by express or overnight mail.
Veradigm will be closely reviewing and providing comments on the Interoperability and Patient Access Proposed Rule to CMS. We are proud to provide initial insight into the changing medical landscape as the health community aims to move toward complete interoperability.