New directives from the Administration focused to eliminate unnecessary regulatory burden

The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) have jointly released a draft titled “Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs” for public comment.
This is an effort, required by Congress by the 21st Century Cures Act, to work with the public on reducing time spent on electronic health records (EHRs) and documentation, to improve usability, and to increase provider satisfaction with the use of EHRs. The draft was released on Nov. 28.

Since EHRs were introduced and then required by the federal government, providers have been expressing their dissatisfaction with them, both in their complexity and their interference with patient care. This is an attempt to correct identified problems. The draft strategy has three overarching goals:

  1. To reduce the effort and time required by clinicians to record health information in EHRs;
  2. To reduce the effort and time required to meet regulatory reporting requirements for clinicians, hospitals, and healthcare organizations; and
  3. To improve the functionality and intuitiveness (ease of use) of EHRs.


CMS considers usability an equal goal to interoperability in moving the industry forward. The government has also established four workgroups to develop draft recommendations in four areas:

  1. Clinical Documentation
  2. Health IT Usability and the User Experience
  3. EHR Reporting
  4. Public Health Reporting

Strategies and recommendations are included in the draft report for these areas. Now, CMS and ONC are reaching out to gather comments and suggestions on the report. This is another opportunity for our audience, and the public in general, to influence the direction of health information technology (HIT) progress in the U.S. The public comment period ends on Monday, Jan. 28, 2019 at 11:59:59 p.m. EST, and I urge folks to read the document and provide input to ONC and CMS.

Eliminating the Health Plan Identified (HPID) and Other Entity Identifier (OEID)

The HPID will no longer be required. A proposed rule eliminating the HPID will be published shortly.

On Sept. 5, 2012, the U.S. Department of Health and Human Services (HHS) published the final rule CMS-0040F, which adopted a unique identifier HPID for health plans. Based on industry confusion and concerns with the requirements, on Oct. 1, 2014, CMS announced a delay, until further notice, in the enforcement of rules for obtaining and using HPIDs. HHS released a request for information (RFI) on May 29, 2015 to solicit feedback from the healthcare community about the HPID. And after reviewing those comments as well as recommendations from the National Committee on Vital and Health Statistics (NCVHS), CMS has issued a rule rescinding the requirements for obtaining and using the HPID. It can still be used on a voluntary basis for those entities that acquired the identifier, but it is expected to see limited use in transactions.

The industry had told CMS that the initial purposes of the HPID (as noted in the HIPAA legislation) have already been accomplished by the industry, so new identifiers were not needed.

Read the CMS/ONC Draft

Program Note: Listen to Stanley Nachimson report his regulatory update today on Talk Ten Tuesdays.


Stanley Nachimson, MS

Stanley Nachimson, MS is principal of Nachimson Advisors, a health IT consulting firm dedicated to finding innovative uses for health information technology and encouraging its adoption. The firm serves a number of clients, including WEDI, EHNAC, the Cooperative Exchange, the Association of American Medical Colleges, and No World Borders. Stanley is focusing on assisting health care providers and plans with their ICD-10 implementation and is the director of the NCHICA-WEDI Timeline Initiative. He serves on the Board of Advisors for QualEDIx Corporation. Stanley served for over 30 years in the US Department of Health and Human Services in a variety of statistical, management, and health technology positions. His last ten years prior to his 2007 retirement were spent in developing HIPAA policy, regulations, and implementation planning and monitoring, beginning CMS’s work on Personal Health Records and serving as the CMS liaison with several industry organizations, including WEDI and HITSP. He brings a wealth of experience and information regarding the use of standards and technology in the health care industry.

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