AMGA recently sent a letter to the United States Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Micky Tripathi, PhD, the National Coordinator for Health Information Technology at the Office of the National Coordinator for Health Information Technology (ONC), objecting to the proposed establishment of disincentives for health care providers that have committed information blocking.
The Department of Health and Human Services (HHS) notes that information blocking is “when a provider knowingly and unreasonably interferes with the access, exchange, or use of electronic health information except as required by law or covered by a regulatory exception.”
The proposed rule would allow for a provider to face exclusion from the Medicare Shared Savings Program (MSSP) for a minimum of one year, if the Office of Inspector General (OIG) found that the provider engaged in information blocking. This may result in a health care provider being removed from an Accountable Care Organization (ACO) or being prevented from joining an ACO. The rule would also allow for clinicians that participate in the Merit-Based Incentive Payment System (MIPS) to receive a score of zero for the Promoting Interoperability category if OIG found that the clinician engaged in information blocking throughout the reporting period calendar year.
The letter references a July 2023 meeting between AMGA staff and the Office of the National Coordinator to discuss certain areas of alignment, particularly with respect to the importance of transparency and access to data among patients, providers, and payers. AMGA notes its continued dedication to “our shared goal of improving healthcare outcomes, facilitating data exchange, and shifting the US healthcare system towards value-based care.” To that end, therefore, the Association raised concerns about the “punitive approach” of the proposed rule, also noting that it “specifically targets physicians practicing in value-based care arrangements” and that it is possible that the proposal will “inadvertently discourage participation in the Medicare Shared Savings Program (MSSP).”
AMGA instead proposed that CMS and ONC revise the proposed rule to allow for a corrective action plan and to allow for providers to appeal the OIG findings, irrespective of which program they are participants. The Association argues that providers should be given an opportunity to work constructively with the federal agencies to address issues related to information blocking, within a reasonable timeframe.
AMGA also recommends in the letter that “CMS maintain a balanced approach to addressing information blocking” and reconsider the severity of the penalties, stating that “implementing less severe consequences would encourage compliance without disproportionately discouraging participation in value-based healthcare models.”
“Patients should have access to their healthcare information,” said AMGA President and CEO Jerry Penso, MD, MBA. “But, just as with other aspects of care, AMGA recommends a collaborative approach to addressing this issue. These proposed penalties jump straight to punishment, when instead providers should have the opportunity to work with regulators to address any concerns or problems.”
Comments were due no later than January 2, 2024. At this point, the agencies will consider the comments that were submitted in evaluating next steps.