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American Hospital Association Opposes Proposed Rule on Information Blocking

The American Hospital Association (AHA) has recently raised concerns about the proposed rule on information blocking put forth by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC).

In a letter addressed to CMS Administrator Chiquita Brooks-LaSure and ONC National Coordinator Mikey Tripathi, the AHA stated that the disincentive structure outlined in the rule is excessively punitive and could jeopardize the financial stability of economically vulnerable hospitals, especially small and rural facilities.

The AHA urged CMS and ONC to reconsider finalizing the disincentive structure and requested transparency in publishing the specific formula used to calculate the potential impact on stakeholders.

Financial Penalties and Impact

According to the AHA, the proposed rule introduces financial penalties for providers found guilty of blocking information sharing, resulting in reduced reimbursement under the Traditional Medicare program. For hospitals paid under the inpatient prospective payment system (IPPS), CMS would decrease the market basket update by 75%, while critical access hospitals (CAHs) would face a 1 percentage point reduction in reimbursement.

The AHA criticized CMS and ONC for underestimating the actual financial impact of these penalties, citing the discrepancy between the agencies’ estimates and those provided by AHA members. The organization expressed concerns that the proposed disincentives could have devastating effects on rural communities, particularly for CAHs already receiving payments below costs.

The AHA recommended that CMS and ONC revisit the application of disincentives through the market basket payment adjustment, highlighting the disproportionate burden that the penalties could impose on certain providers.

The Larger Trend and Concerns

With close to 5,000 member hospitals and health systems, the AHA stressed its apprehension about the uncertainty surrounding the Office of the Inspector General’s determination of information blocking and the appeals process. The organization also emphasized the potential for unfair and confusing punishment under the proposed rule, further complicating the regulatory framework for providers.

If finalized, the rule would mark the program’s fourth update since 2019, adding to the existing burden and confusion for healthcare providers. The AHA recommended that disincentives related to Accountable Care Organizations (ACOs) be introduced in a separate rule, allowing for thorough consultation with ACO administrators to understand the potential impact of any proposed penalties.

How AI legalese decoder Can Help

The AI legalese decoder can assist healthcare providers and legal teams in interpreting and understanding complex regulatory language, such as the proposed rule on information blocking. By employing natural language processing and machine learning algorithms, the tool can parse through the intricate legal text and provide simplified explanations, ensuring that organizations have a clear understanding of the regulatory implications and potential penalties. Additionally, the AI legalese decoder can aid in identifying the specific formula used for calculating the financial impact, as requested by the AHA, thus facilitating transparency and informed decision-making.

Twitter: @SusanJMorse
Email the writer: [email protected]

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