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What the CMS Interoperability and Patient Access Final Rule Means for Your Clinic

Medical Billing

Earlier in 2020, CMS released the Interoperability and Patient Access Final Rule, and policy that impacts a wide variety of care providers in an effort to provide patients with better access to their health information. The rule, which was slated to go into effect over the course of 2020 and be in effect by January 1, 2021, has been postponed in light of the COVID-19 pandemic. Here’s what that means for your clinic.

What’s in the Final Rule

The goal of the Interoperability and Patient Access final rule (CMS-9115-F) is to provide patients with easier access to their health information, or “liberating” patient data so it can be easily shared among different providers and healthcare systems. The rule includes several parts that were scheduled to go into effect beginning in late 2020 through 2022:

  • Public reporting and information blocking (2020)
  • Digital contact information (2020)
  • Patient access API (January 1, 2021)
  • Provider directory API (January 1, 2021)
  • Admission, discharge, and transfer event notifications (Spring 2021)
  • Payer-to-payer data exchange (January 1, 2022)
  • Improving dually eligible experience by increasing the frequency of federal-state data exchanges (April 1, 2022)

More information with details on each individual part of the new rule is included on the Fact Sheet on CMS’ website.

What’s Changed

When the rule (and the subsequent dates for implementation) were released, it was before anyone could foresee the impact of COVID-19 on the healthcare system in the U.S. Since that time, we have experienced an unprecedented global pandemic that has disrupted even the most basic care for many patients and providers.

As a result, CMS announced that the final rule will not go into effect with the original dates, but will instead be pushed back. The first part that was scheduled to go into effect (admission, discharge, and transfer, or ADT, notifications, will be pushed back to 12 months from the publication date in the Federal Register, which was June 30, 2020. Implementation for other parts of the rule will also be pushed back to allow healthcare providers and systems time to overcome the challenges presented by COVID-19. However, the schedule remains the same for items that go into effect in 2022.

What it Means for Your Clinic

Even if you run a small or independent medical practice, these rules will still impact you, and you will still need to have the technology in place to comply with information and data sharing requirements. For clinics that might not have a large IT staff to help, that’s where your clinical software vendor comes in. AdvancedMD has the expertise and experience to ensure that your practice management software and EHR are equipped to share information appropriately, securely, and safely to comply with this and other mandates.

In a world that is increasingly interconnected, having the right practice management system can make all the difference. Find out more about how you can get the right software in place for your practice today.



Topic: Medical Billing


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