Verma says interoperability rule is coming, backs data sharing as a Medicare requirement

Doctor computer medical records
Verma said making data sharing a Medicare requirement would be "much easier, to some degree, for hospitals and physicians." (Getty/BrianAJackson

A much-anticipated proposed rule on interoperability should be coming “shortly,” according to a top Trump administration official.

“Hopefully in the next couple of weeks we’ll have some more clarity,” Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma told reporters on Tuesday.

A rule titled “Interoperability and Patient Access” is still under review by the Office of Management and Budget. The proposal, deemed “economically significant,” vaguely says it will “move the health care industry toward a more accessible and interoperable health care ecosystem.”

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While Verma didn’t comment on the specifics of the rule, she threw her support behind requiring health systems and physician practices to provide patients access to their medical records in order to participate in Medicare.

RELATED: Verma calls on insurers to use APIs. Some answer more enthusiastically than others

CMS first floated that idea in April and has included a request for information in nearly all of its payment rules this year. Verma noted that the government has spent nearly $36 billion on EHR adoption, but most patients still can’t access their medical records. Building that requirement into Medicare Conditions of Participation and Medicaid Conditions for Coverage are levers the administration can pull.

“I think that’s much easier, to some degree, for hospitals and physicians where they were funded to essentially have the electronic health records—a little bit more of a thorny issue when it comes to post-acute care providers where some of them don’t have an EHR,” she said.

The administration’s MyHealthEData initiative is predicated largely on the idea that patients deserve full access to their medical records in electronic form.

RELATED: AHA ‘strongly opposes’ interoperability as a Medicare requirement

But changes to Medicare requirements would meet stiff resistance from provider lobbying groups like the American Hospital Association, which has said it “strongly opposes” such a proposal.

Verma also highlighted progress in the administration’s Blue Button 2.0 program, aimed at putting Medicare claims data in API form. To date, 1,500 developers are in the program, she said. Verma has previously warned commercial insurers that they need to make claims data available to members.

“Obviously, privacy and security are of top concern, but they are finding ways to take that data and turning it into apps,” she added. 

Tina Reed contributed to this story.

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