AHA ‘strongly opposes’ interoperability as a Medicare requirement

Doctor computer
AHA said making interoperability a condition of Medicare participation could create “unfortunate consequences for some hospitals and communities.” (Getty/andrei_r)

The American Hospital Association (AHA) has come out against a policy floated by the Centers for Medicare & Medicaid Services (CMS) to make interoperability a requirement to bill Medicare and Medicaid.

In a proposed hospital payment rule issued in April, CMS included a request for information regarding a revision to hospital Conditions of Participation (CoP) and Medicaid Conditions for Coverage (CfC) that would require hospitals to share data electronically with other hospitals, community providers and patients “if possible.”

In comments (PDF) submitted to CMS, the AHA said it “strongly opposes creating additional CoPs/CfCs to promote interoperability of health information.”


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“The AHA strongly supports the creation of an efficient and effective infrastructure for health information exchange,” the nation’s largest hospital advocacy grout wrote in their letter. “This is central to the efforts of hospitals and health systems to provide high-quality coordinated care, support new models of care and engage patients in their health.

"However, we do not believe a new mandate tied to CoPs is the right mechanism to advance health information exchange," the group added. 

RELATED: CMS floats proposal tying medical records sharing to Medicare participation

CoPs are viewed as a far heftier regulatory stick, and hospitals are resistant to additional requirements that have huge repercussions for noncompliance. CMS Administrator Seema Verma has made interoperability one of her primary objectives, rolling out new initiatives this year aimed at getting data in front of patients.

 AHA said the rule unfairly targets one set of actors in the healthcare ecosystem and that new requirements could have “unfortunate consequences for some hospitals and communities.”

RELATED: CMS launches new initiatives to expand patient access to health data, plans ‘complete overhaul’ of Meaningful Use

The group argued that it's premature to consider building interoperability into CoPs or Medicaid's CfCs until the barriers to data sharing have been fully addressed, noting that post-acute care providers, in particular, are often behind the curve with EHR implementation.

AHA also argued that compliance would be difficult for surveyors to measure, and providers can deliver care safely without interoperability.

“Instead, the AHA urges CMS to focus its attention on resolving problems created by the lack of a fully implemented exchange framework, adoption of common standards and incentives for EHR and other IT vendors to adhere to standards,” AHA said, pointing to the Trusted Exchange Framework and Common Agreement (TEFCA) release by the Office of the National Coordinator for Health IT earlier this year.

AHA also said it opposes the use of Stage 3 requirements in fiscal year 2019, a transition included in the proposed rule that would require hospitals to upgrade their EHR systems. The group was largely supportive of the agency's proposal to rebrand the Meaningful Use program as "Promoting Interoperability" and altered its scoring system.

AHA wasn’t the only organization opposed to building interoperability into CoPs. The College of Health Information Management Executives (CHIME) said in a letter to CMS that new regulations are unnecessary, and that CMS should let existing policies such as data blocking and TEFCA to “take root" before implementing more stringent requirements.

Likewise, the American Medical Informatics Association (AMIA) said the data blocking rules "will be sufficient in stemming the nefarious aspects of information blocking, especially for provider-to-provider exchange” and recommended CMS implement those policies before moving on to Medicare and Medicaid requirements.

Comments were still filtering in on Monday ahead of the midnight deadline.

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