The Centers for Medicare & Medicaid Services (CMS) recently released a wealth of new guidance and resources for MIPS Promoting Interoperability (PI) measures and program requirements for the 2021 reporting period. These changes are based on the IPPS (or inpatient) rule. However, the guidance released in the IPPS rule is usually mirrored in the outpatient rule, which should be released later this summer. As usual, there is a lot to go through. However, most requirements are being carried over from 2020 so only a handful of changes need to be noted by our readers (have no fear; we’ve already done the grunt work, so you don’t have to).
While the HIPAA Right of Access rule was first passed into law as part of the 2013 HIPAA Omnibus Rule, the Office for Civil Rights (OCR) has been cracking down hard on violators of this rule in recent years. This provision requires covered entities to provide patients with a copy of their medical records in the form and format requested, or another agreed upon form, within 30 days of the initial request. If the covered entity is unable to fulfill the request in that timeframe, they may notify the patient in writing that they will need a 30-day extension. This notification must also notify the requestor of the date on which the records will be provided and only one extension is permitted.
We are entering a new era of healthcare, one where the patient is empowered to direct his or her own treatment. Patients are more informed and involved in their care than ever before and app developers are tapping into people’s desire to be involved in the decision making when it comes to their care. They also expect to be readily provided with their healthcare information upon request, and legislation has been passed that will require such requests be fulfilled in a timely manner.
The submission window for MIPS Performance Year (PY) 2020 closes on March 31, 2021. As one year closes another begins, and now is the time that practices should be preparing for their 2021 MIPS reporting. For the new year, the MIPS annual program requires submission of data in four categories—Quality, Promoting Interoperability (PI), Improvement Activities (IA) and Cost. In this blog, we will briefly go over actions to be taken throughout the year for submission in PY 2021 so that our readers can be better prepared for the next MIPS reporting period.
On December 10th, 2020, the Office for Civil Rights released a proposed rule to modify the current HIPAA Privacy Rule. While this rule is not yet finalized, it is important that practices are aware of the proposed changes and begin to prepare for the new level of interoperability and sharing that is reflected in these proposals. The changes in the proposal align closely with the ONC’s Cures Act final rule, which was finalized almost a year ago, with changes that will increase the ability to coordinate care across systems as well as allow patients to access and direct their own care.
On October 30, 2020, the U.S. Department of Health and Human Services (HHS) announced the publication of its final 2020-2025 Federal Health IT Strategic Plan. Developed by the HHS ONC in collaboration with 25 federal organizations and formed with input from 100 public comments, this plan outlines federal goals and objectives for Health Information Technology (Health IT) and focuses specifically on the access of individuals to their electronic health information.
UPDATE: This blog has been edited from its original version to reflect new changes to the CMS timeline for these requirements. The upcoming Information Blocking deadline (November 2, 2020) is drawing near, and many providers are still unaware of, or confused by, what will be required of them under the new guidelines. In this blog, we will offer readers a bit more clarification. Most providers have already heard about the 21st Century Cures Act and the rule that the ONC released earlier this year outlining new requirements for complying with it. The rule outlines the updates that EHR vendors must make to their platforms and receive certification for by early 2022, as well as electronic protected health information (EPHI) sharing requirements for providers. This rule is highly focused on allowing the free flow of information required for patient care between providers, as well as increasing patients' access to their own electronic health information (EHI). It accomplishes this goal by, among other things, updating EHI interoperability language to US Core Data for Interoperability (USCDI) and through requiring use of FHIR r4 APIs by EHR vendors. This will, in effect, make it so that disparate EHRs “speak the same language,” and will allow for the electronic exchange of previously unavailable EHI content, such as narrative notes, vital signs and test results.
One of the first things that providers learn about the billing system used for CMS is how to use the evaluation and management (E/M) codes 99201-99215 for initial and follow-up office visits. These codes were established in 1995, revised in 1997 and have not changed in over 20 years--until now. These codes provide physicians and other billing providers a way to indicate to payers just how much detail they had to go into while treating the patient, and correspondingly, how much they should be paid for the visit.