Healthcare providers are facing penalties for blocking access to a patient’s electronic health information under a new Biden administration rule.

On June 24, the U.S. Department of Health and Human Services (HHS) finalized a rule (RIN: 0955 - AA05) that penalizes hospitals in the Medicare Promoting Interoperability Program that block health information sharing by stripping their meaningful electronic health record user status. “Meaningful use” carries financial incentives. Hospitals that commit “information blocking” can be prevented from earning 75% of their annual market-based increase.

Accountable Care Organization health providers caught blocking information may be banned from the Medicare Shared Savings Program for at least a year, cutting off a revenue stream.

Penalties apply to providers that the HHS Inspector General determines have “committed information blocking,” according to the rule.

HHS Secretary Xavier Becerra characterized the rule as a way to ensure patients can always access their health information.

The rule also lays out a process for sharing information with the public when Office of Inspector General catches health providers and others blocking health information.

HHS noted in a statement that, “additional disincentives may be established through future rulemaking.”

Despite the requests of provider and hospital groups, the rule doesn’t create an appeals process for penalized entities.

Last summer, the agency estimated that the typical fines for hospitals would be $394,000 and $686 for individual providers for blocking patients from accessing data.

The final rule comes a year after HHS finalized a similar regulation subjecting non-provider individuals or entities, like health IT vendors, to up to $1 million penalties if they refuse to share patient data.

The Nelson Mullins team is experienced in healthcare regulatory matters. Please reach out to one of our authors Jacob Kohn or Ed White for any questions regarding this topic.

Dates: Effective July 31, 2024

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