The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) finalized rules March 9th, 2020 requiring major changes for payers and hospitals to provide patients unprecedented safe access to their own health information. The rules address interoperability, information blocking, patient access to data and electronic health record (EHR) certification. In most cases, compliance calls for implementing significant data transparency requirements.
CMS mandates that hospitals and health systems connect admission, discharge and transfer (ADT) systems ASAP. Within just six months or effective September 9, 2020, providers must electronically send ADT alerts to community providers when patients are seen in the emergency department or admitted to, discharged and/or transferred from the hospital to another community provider or practitioner.
This timeline is aggressive and appropriate. ADT alerts improve care quality and reduce readmissions. Notifications further help primary care providers keep track of patients during public health crises, most notably the COVID-19 (coronavirus) pandemic. Now CMS is requiring these hospitalization alerts as a condition of participation in Medicare and Medicaid: https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index.
Additional time-sensitive requirements include:
Hospitals must start sending ADT notifications to patients’ physicians in a little more than six months. Payers have until the end of the year.
CMS will start publicly reporting the identity of clinicians, hospitals and critical access hospitals “information blocking” in late 2020.
Many health plans will need to start sharing claims, cost and health information electronically with patients. Medicaid, the Children’s Health Insurance Program (CHIP), Medicare Advantage (MA) plans and qualified health plans must make enrollee data immediately accessible.
The State Health Alliance for Records Exchange (SHARE) is prepared to support healthcare providers throughout Arkansas and border Hospitals. We are ready to help participants comply with the final rules and implement our HIE date exchange to make protected patient health information more interoperable.
We are offering incentives (NO Implementation Costs) to offset costs hospitals and health systems for participating in the SHARE network sharing ADT notifications by September 2020.
Interested organizations can contact:
Office of Health Information Technology, a Division of Arkansas Department of Health
State Health Alliance for Records Exchange (SHARE)
Email: [email protected]
Admission, Discharge, and Transfer Event Notifications: CMS is modifying Conditions of Participation (CoPs) to require hospitals, including psychiatric hospitals and CAHs, to send electronic patient event notifications of a patient’s admission, discharge, and/or transfer to another healthcare facility or to another community provider or practitioner. This will improve care coordination by allowing a receiving provider, facility, or practitioner to reach out to the patient and deliver appropriate follow-up care in a timely manner. This policy will be applicable 6 months after publication of this rule.
To view the CMS Interoperability and Patient Access final rule, visit https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index.