Although it was signed into law in 2016, portions of the 21st Century Cures Act, the provisions designed to support interoperability continue to create the need for new rules by the Centers for Medicare and Medicaid Services and the Office of National Coordinator for Health IT.

The CMS Interoperability and Patient Access Rule and ONC Interoperability Rule were finalized in May 2020. Although Covid-19 delayed enforcement, that’s about to change.

One requirement that both payer systems and electronic health records (EHRs) must be capable of exchanging medical information through patient and provider APIs are critical to eliminate information blocking and siloed information that can thwart interoperability. The CMS rule requires an API for payer-to-payer information exchange. 

Another component of the rule takes a tougher stance on price transparency. It increases the penalty for hospitals that do not comply with the Hospital Price Transprarecy final rule. The fines established by CMS start at $300 per day for smaller hospitals with a bed count of 30 or fewer, and a penalty of $10 per bed per day for hospitals with a bed count greater than 30, according to a CMS press release.

This webinar sponsored by Intelligent Medical Objects will explore how payers are meeting these needs when it comes to providing access to structured medical data for members.

Among other topics the webinar discussion will highlight are:

• Creating cohorts for patients with chronic conditions
• How cohorts can be used for population health
• Price transparency 
• Risk mitigation
• Coordination of information blocking rules with ONC, OCR, CMS
• Implications for standardizing and normalizing data
• Recently proposed changes to HIPAA

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