HIMSS 2022: Becerra, Brooks-LaSure say provider info blocking penalties, revamped interoperability rule on the horizon

In a Tuesday session at HIMSS 2022, Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) leaders said shortcomings in data sharing rules and enforcement are having a clear impact on health equity in America and vowed to take action to close those gaps.

Speaking virtually in a prerecorded video address for attendees, HHS Secretary Xavier Becerra ran down some of the department's recent health IT accomplishments, such as the implementation of the Trusted Exchange Framework and Common Agreement.

However, he also acknowledged that “our job is far from finished” in other areas such as enforcement of the information blocking rules outlined in the 21st Century Cures Act. Live as of last April, the regulation requires health IT vendors, providers and health information exchanges to enable patients to access and download their health records with third-party apps.

However, the 21st Century Cures Act only specified civil monetary penalties for technology developers and health information networks, leaving provider penalties up to HHS to define.

A recent report from the Office of the National Coordinator of Health IT found that providers were cited in 77% of all info blocking complaints received by the government. Becerra highlighted one of these complaints, in which a patient was told to wait weeks for their request because a physician was on vacation.

“That’s not the kind of customer service we should expect from a 21st century healthcare system—and that’s just one of hundreds of complaints that we’ve received so far,” he said. “Put simply, closing this enforcement gap is an HHS priority. We’re working hard on this issue and will have more to share with you later this year.”

In a live virtual address immediately following Becerra’s comments, CMS Administrator Chiquita Brooks-LaSure said her agency would be pulling its own levers to address providers’ info blocking.

“As the largest payer in the world and the largest regulator of providers in the country, CMS has a significant interest in these penalties, and we are actively working with our partner agencies across HHS to ensure that we close this gap,” she said to HIMSS attendees over a livestream. “We are so grateful [for] the support from Secretary Becerra’s office in helping us address this issue for people everywhere.”

Brooks-LaSure also took time to address the Interoperability and Patient Access final rule issued in 2020. Although it represented a “significant” first step toward easy and secure data sharing, the administrator acknowledged that her agency will need to take another crack at the policy to fully achieve its goals.

“The policy that CMS finalized did not quite hit the mark, unfortunately, because we didn’t require standardized [application programming interfaces (APIs)],” she said. “Our interoperability rule wasn’t interoperable enough, and it led to many open questions about how data should be exchanged. It’s vital that the policy supports people in the ways that they need and that payers are able to successfully implement those new features.”

Brooks-LaSure said CMS is now working on additional rulemaking to rectify its payer data exchange policy, notably via the inclusion of APIs using the HL7 FHIR standard.  

“Because of your public comment on our prior rules and because of the feedback you’ve provided through various forms, we will publish a rule that is responsive to our stakeholders’ needs in regard to advanced data exchange,” she said. “We look forward to sharing this new rule with you soon and to the data exchange it will support.”

Other stops on the federal government’s 2022 road map include digital quality measures that reduce collection burden on providers and enable broader data analytics, continued work on prior authorization that reduces the burden on all parties and “a deep look” at algorithmic bias and the impact it may have on health equity, the agency leaders said.