On November 1, the Centers for Medicare & Medicaid Services released a proposed rule that establishes penalties for healthcare providers that have committed healthcare information blocking, defined as “a practice that is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information.” The proposed policies would implement provisions contained in the 21st Century Cures Act, which established the sharing of electronic health information as the expected norm in health care. In addition to holding an information session on the proposed rule, additional resources on information blocking are available from the Office of the National Coordinator for Health Information Technology. CMS is accepting comments on the proposed rule until January 2, 2024.
There are two proposals within the rule that directly affect physicians. The first is under the Quality Payment Program. If a physician commits “information blocking” and is an eligible participant in the Medicare Merit-based Incentive Payment System (MIPS), then the physician would not be a meaningful user of electronic health records, and therefore would receive a score of zero in the MIPS meaningful use of the Electronic Health Record component, which comprises a quarter of physician’s total MIPS score.
Second, if a physician is participating in an accountable care organization (ACO), and the physician has been determined to be an information blocker, the physician will be banned from participating in an ACO for one year. Banning the physician from participation in an ACO prevents them from receiving additional revenue they might have gained under the shared shavings of the ACO.