In May 2021, the Information Blocking rule became effective in the U.S., forbidding “actors” from interfering with the access, exchange, or use of electronic health information (EHI). For the purposes of this law, “actors” are “health care providers, health IT developers of certified health IT, and health information exchanges or networks” who are sharing data across two or more entities.
In order to make rollout gradual and achievable, the Office of the National Coordinator (ONC)—the federal agency which issued this rule—started off with a narrow definition of what counted as EHI. Initially, EHI (again, only for purposes of Information Blocking) was limited to the discrete set of data contained in Version 1 of the U.S. Core Data for Interoperability (USCDI) set.
On October 6, 2022, the honeymoon period of information blocking compliance with a well-defined and relatively manageable data set ended, and a new era in health data sharing began. Going forward, the EHI that “actors” must exchange is now the entire EHI data set as defined by the Health Insurance Portability and Accountability Act (HIPAA) in 45 CFR 171.102. The only two exclusions from the EHI set are psychotherapy notes (as defined in 45 CFR 164.501) and information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding.
If your business is considered an “actor” in this space, compliance with this transition is extremely important. The ONC rule authorizes the Office of the Inspector General (OIG) to impose civil money penalties of up to $1 million dollars per incident. Although OIG has not yet finalized their proposed enforcement rule, the agencies are recording complaints and it is possible that they will seek to penalize “actors” retroactively for violations that occur in this interim period.
Elevation Health Consulting can help you determine whether your business counts as an “actor,” what EHI your business is required to share, who your business is required to share it with, within what time frame the sharing must occur, and which exceptions you may be able to invoke. Get in touch with
us today to get started!
