ISMS Offers Resource Explaining New Federal Rule on 'Information Blocking'

January 22, 2020

In 2015, the Centers for Medicare and Medicaid Services (CMS) began paying separately for non-face-to-face care coordination services provided to Medicare beneficiaries with multiple chronic conditions. CMS reimbursed practitioners approximately $43 per patient per month for 20 minutes of care management services billed under AMA CPT code 99490.1

In 2016, the 21st Century Cures Act was signed into law. The Cures Act includes provisions to promote interoperability of electronic health records (EHR) and prevent entities, including physicians, from “information blocking,” a practice that impedes access to and the exchange of relevant information contained in an individual’s electronic health record.

In 2020, the Office of the National Coordinator for Health Information Technology (ONC) released a final rule implementing the EHR-related provisions in the Cures Act. While many of the provisions in the Cures Act and the accompanying ONC regulations apply primarily to developers of EHR technology and to large entities such as payers or large health care systems, there are important rules that individual physicians and physician groups need to understand if they use EHR technology in their practices.

We have assembled the following “Frequently Asked Questions” based on questions we have received, as well as communications we have had with the American Medical Association regarding their ongoing advocacy with federal officials about the potential impact of these rules on physician practices and patient care.

Note that the ONC information blocking rules are complex, and these FAQs provide only a high-level overview of some key issues of which practices should be aware. Additional general information is available from the American Medical Association and on the ONC website. For more specific information about how these regulations apply to your practice, we strongly encourage you to seek advice from legal or other experts who can work directly with your practice to ensure regulatory compliance.

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