New guidance for MACRA reporting: Attestation against information blocking
- CMS issued guidance for providers on when and how to attest that they are not engaged in data blocking and readily share information with their patients. The guidance is aimed at providers participating in the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program.
- Under the 21st Century Cures Act, providers and EHR vendors are prohibited from blocking information. Otherwise, they could face fines of up to $1 million per violation for doing so.
- Some providers expressed concern that the guidance lacks clarity on when they won’t be held accountable for factors beyond their control and the meaning of “reasonable attempts” at interoperability, Modern Healthcare reported.
According to the guidance, providers must confirm that they took reasonable steps to implement their certified EHR technology in a way that permits sharing of health information. At the same time, CMS says it does not expect providers to have the technical skills necessary to implement their EHRs or direct knowledge of standards and policies.
“We recognize that circumstances beyond a MIPS eligible clinician’s control may limit the exchange or use of electronic health information,” the guidance says. “This is why the Prevention of Information Blocking Attestation focuses on whether you act in good faith to exchange electronic health information and your particular situation.”
Providers worry, however, that what they consider a good faith effort to comply may not hold up under CMS’ scrutiny.
In August, McKesson, a group of health IT and provider organizations urged HHS and ONC to issue a proposed rule clarifying the meaning of information blocking and how enforcement will be applied. Their aim was to make crystal clear what can be maintained as proprietary information and what amounts to undermining interoperability efforts.
Under MIPS, providers are eligible for either financial incentives or penalties based on their performance in three categories: quality, advancing care information and improvement activities. A fourth category, cost, will be added in 2018. The MACRA final rule requires providers to attest that they haven’t knowingly impeded information exchange and to report suspected cases of information blocking.