The rule does not set requirements for the privacy and security of the apps and the data they contain.
The Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS) final interoperability rules were released last week, about a year after the proposed rules were published.
These groundbreaking rules provide requirements for electronic health records (EHRs) and federally administered health plans to make data available to patients in a standardized, mobile-friendly method, using HL7 FHIR standards. The rules also provide strict prohibitions against data blocking (like excess charges or technological hurdles), as well as specific exceptions to the prohibition (for privacy and security issues).
The rules will provide patients the ability to select their own applications to download certain clinical data from provider EHRs and claim data from the health plans. The clinical data exchange will also take place among providers, enabling them to share data from their EHRs in a standardized manner.
While the application exchange requires only a certain subset of data to be available, EHRs will also be required to make the complete set of data for a patient available for exchange, as well as a complete set of data for all patients. This will make switching providers easier for patients, and switching EHRs easier for providers.
The CMS rule also requires Medicare-participating acute-care hospitals, long-term care hospitals, inpatient rehabilitation facilities, psychiatric hospitals, children’s hospitals, cancer hospitals, and critical access hospitals to send electronic notifications to receiving providers when an inpatient is admitted, discharged, or transferred.
While the notification requirement mentioned above will be required six months after the rule is published, there are much longer time frames for the exchange requirements.
Some of the key dates include the following:
ONC and CMS envision a robust market of applications for consumers to use in both acquiring their data, and more importantly, using their data to help manage their health. The rule sets the standards for the data acquisition, but does not set any other requirements for the application capabilities or the privacy and security of the apps and the data they contain.
The final rule made some minor changes to definitions and some of the blocking criteria, as well as revising the compliance dates. Despite the long time between the proposed and final rules, there does not appear to be any significant changes between them.
Worth a second read considering the fatal shooting of the CEO for United Healthcare. The Centers for Medicare & Medicaid Services (CMS) has outlined critical
The Centers for Medicare & Medicaid Services (CMS) has outlined critical updates to clarify the definition and processes surrounding organization determinations, particularly in inpatient settings.
Please log in to your account to comment on this article.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
Copyright © 2024 ICD10monitor. Powered by MedLearn Media.
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
