On Nov. 1, 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) published a proposed rule to specify the “appropriate disincentives,” as required under the 21st Century Cures Act (P.L. 114-255) for health care providers determined to have committed information blocking by the HHS Office of the Inspector General (OIG). These proposed disincentives are separate and distinct from the civil monetary penalties finalized earlier this year by the OIG for other regulated actors under the information-blocking rules [refer to Washington Highlights, March 13, 2020].
Notably, the proposed rule would penalize certain providers under existing Medicare programs. Those include 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 propose 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. The proposed rule also includes a policy to publicly identify actors who committed information blocking and any settlements, civil monetary penalties levies, and disincentives administered on the ONC’s website.
Comments are due Jan. 2, 2024.
- Washington Highlights