Providers and Payers Should Adopt Open-Industry Standards to Advance Interoperability
Two new rules aim to reflect the deep collaboration between CMS and ONC to ensure that providers and payers adopt common, open-industry standards to advance interoperability and industry innovation.
As highlighted in a recent ONC Health IT Buzz blo CMS’s Advancing Interoperability and Improving Prior Authorization Processes proposed rule both build on the 2020 Patient Access and Interoperability rule.
According to the ONC, these two rules would “advance electronic health information exchange and streamline cumbersome health care processes by establishing standardized requirements across the industry.”
If finalized, the proposed law would require healthcare payers to:
Establish application programming interfaces (APIs) to share information with healthcare providers about patients covered under the plan.
Share information with other payers when patients change plans.
Allow providers to easily obtain coverage requirements for items and services that require prior authorization
Submit information needed to request authorization.
The ONC blog post also highlighted how the public is invited to submit comments on CMS’ proposed rule through March 13, 2023.
In other health data exchange news, Chief Healthcare Executive recently published an article about how a wide exchange of healthcare data between hospitals, insurers, practices, and patients will eventually be a game-changer.
However, data blocking remains to be a challenge with HHS yet to introduce penalties for those refusing to share health data.
In 2020, Mariann Yeager, CEO of The Sequoia Project, did a RosettaHealth podcast interview with us about the information blocking challenge. The Sequoia Project offered an Information Blocking Compliance Boot Camp, as well as a number of compliance resources in the form of free tools, checklists, reports and webinars.
Late last year, The Sequoia Project took things one-step-further by releasing the final version of the set of resources designed to help regulated entities better comply with the information blocking requirements. In February, the organization also launched its Consumer Voices Workgroup to get insights for patients, caregivers, and care partners about how they can view their own medical records and health data.
We hope that all of the new rules around interoperability and information blocking will bring the vision of health data exchange – where patient outcomes are improved and costs are reduced – fully to life.
smission of case reports from electronic health records to public health agencies for review and action.
RosettaHealth can assist with any health information challenges you might have, book a free consultation with one of our interoperability experts.