HHS Establishes Information Blocking Disincentives for Providers

The Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC) together with the Centers for Medicare & Medicaid Services (CMS) released a final ruleto establish "appropriate disincentives," as required under the 21st Century Cures Act (P.L. 114-255, PDF) for health care providers determined to have committed information blocking by the HHS Office of Inspector General. The AAMC commented on the proposals at the end of last year [refer to Washington Highlights, Jan. 12].

The agencies finalized penalties for certain providers under the following existing Medicare programs. This includes hospitals under the Medicare Promoting Interoperability Program (impacting 75% of the annual market basket update that hospitals receive under the Inpatient Prospective Payment System) and clinicians through the Promoting Interoperability performance category of the Merit-based Incentive Payment System (impacting payment adjustments to the Medicare Physician Fee Schedule). The agencies also finalized the proposals to bar participation for one year from the Medicare Shared Savings Program by any health care provider that is an accountable care organization (ACO), ACO participant, or ACO provider or supplier found to have committed information blocking and to publicly identify on the ONC website any actors who committed information blocking as well as any settlements, civil monetary penalties levies, and disincentives administered.

The rule will be effective 30 days after it is formally published in the Federal Register. Disincentives will apply to any conduct on or after the effective date, though the prohibition from participation in the Medicare Shared Savings Program will not be effective until January 2025.