On March 9th, 2020, the Office of the National Coordinator (ONC) released two new regulations for the 21st Century Cures Act. Both rules deal with patient access, interoperability, and information blocking among healthcare providers. The process of implementing these two new rules is designed to take place over a couple of years. By January 2022, healthcare providers must meet all compliance regulations included in the Final Rule.
To help you stay on track toward successfully adopting these new rules, Iron Bridge — a leading healthcare API expert — offers a timeline for implementation in its latest blog post.
Everything You Need to Know About the Final Rule and its Impact on Healthcare APIs
A Healthcare API Expert Explains the New Regulations Included in the Final Rule
Historically, the lack of seamless and efficient data exchange among healthcare providers has proven to be detrimental to the health of patients. High medical costs and poor health outcomes can result from this lack of accessibility to patients’ health information.
The Final Rule: 21st Century Cures Act is designed to empower patients by giving them access to their health information. They should be able to access this information whenever they need it in the most convenient way possible. As a result of this improved interoperability, clinician burdened is reduced. This can also lead to improved outcomes and better care for patients.
The full list of policies focus on the following:
- Patient Access API: CMS-regulated payers must implement a standardized healthcare API that lets patients access claims and encounter information
- Provider Directory API: CMS-regulated payers must make their provider directory information publicly accessible through a standardized healthcare API
- Payer-to-Payer Data Exchange: CMS-regulated payers must exchange certain patient clinical data at the patient’s request
- Improving Dual Eligibility by Increasing the Frequency of Federal-State Data Exchanges: Updated requirements for states to exchange certain enrollee data for individuals who are dually eligible for Medicare and Medicaid
- Public Reporting and Information Blocking: CMS will publicly report clinicians, hospitals, and critical access hospitals (CAHs) that may be information blocking
- Digital Contact Information: CMS will also publicly report providers who do not list or update their contact information in the National Plan and Provider Enumeration System (NPPES)
- Admission, Discharge, and Transfer Event Notifications: CMS will modify Conditions of Participation (CoPs) to require hospitals to send electronic patient event notifications of a patients’ admission, discharge, or transfer to another healthcare facility
Full Timeline for Implementing the Final Rule
Make Sure You Meet These Upcoming Deadlines
Due to the COVID-19 pandemic, the ONC added extra flexibility to the original timeline. For some, this includes three to six months of enforcement discretion. The full timeline for implementation should take healthcare professionals around three years to finish. Take note of the following provisions and timelines to ensure you are following along at a reasonable pace.
On March 9th, 2020, the Human Health and Human Services (HHS) and ONC released the Final Rule: 21st Century Cures Act on Interoperability, Information Blocking, and the ONC Health IT Certification Program.
The final rule is effective starting on June 30th, around several months after its initial announcement.
Starting 6 months after the publication of the final rule, health IT developers will be prohibited from blocking the access, exchange, or use of electronic health information (EHI).
By March 2021, healthcare providers must be in compliance with a number of areas regarding information blockings, assurances, and various APIs. The ONC recommends making steps toward implementing these provisions in September of 2020.
The Centers for Medicaid and Medicare (CMS) must publicly report clinicians, hospitals, and critical access hospitals that they suspect are engaging in information blocking. CMS must also publicly report any providers that do not list or update their contact information in the National Plan and Provider Enumeration System. By March 2021 hospitals should also start electronically sharing all pertinent patient information and ADT event notifications with their patient’s primary physicians.
January 2021-July 2021
Providers should also start working toward meeting criteria for patient access and provider directories starting in January 2021. Throughout these six months, CMS-regulated providers must implement HL7 FHIR API capabilities in order to give patients quicker access to their claims and health information. Providers must also create a public provider director using a standards-based API.
Healthcare providers must become fully compliant to the Final Rule no later than 36 months after its publication in January of 2019.
A Healthcare API That Enables Effective Inoperability
Working toward achieving full compliance with the Final Rule while managing the COVID-19 pandemic is a challenge that many healthcare providers are currently facing. One of the top-rated IT solutions for providers is the fhirstation by Iron Bridge, a patient access solution for EHR vendors and payers.
Fhirstation is a turn-key scalable, multi-tenant Software as a Service (Saas) solution for EHR vendors, hospitals, and other healthcare providers. Some of its key features include:
- Data storage in native FHIR v4 data models
- Powerful data analytics for building a customized data lake
- Implementation services for unlocking EHRs and health plan data
- Adapters for translating EHR and other health plan data into FHIR data models
- The ability to isolate customer data down into a single EHR location
Interesting in learning more about fhirstation and its role as a leading healthcare API? Contact the team at Iron Bridge today for more information.