What Physicians Need to Know about Information Blocking Rules

Last year, the Office of the National Coordinator for Health Information Technology (ONC) released a rule implementing provisions of the 21st Century Cures Act, requiring physicians to comply with new regulations on the access, exchange and use of patients' electronic health information (EHI), according to the American Medical Association (AMA). Information blocking is defined as practices that are likely to interfere with, prevent, or materially discourage the access, exchange or use of EHI.

Physicians, hospitals, electronic health record (EHR) vendors, health information exchanges (HIE) and health information networks (HIN) are all subject to ONC's rule and are collectively referred to as “Actors.” Actors whose actions are likely to interfere with the access, exchange, or use of EHI could be considered information blockers and subject to penalties or disincentives. EHR vendors and HIE/HINs can receive up to $1 million in civil monetary penalties per violation. Penalties and other “disincentives” for physicians and other health care providers have yet to be determined by the U.S. Department of Health and Human Services (HHS). However, physicians participating in the Promoting Interoperability (PI) Program could see an impact to their Centers for Medicare & Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS) incentives if they are found to be information blockers.

The AMA is urging HHS to refrain from creating any new or additional physician penalties, and they are staying engaged with the Biden administration to address concerns that the HHS’ rule forces physicians to release office notes and test results prior to physicians reviewing the information with the patient. The AMA is working to reduce the complexity and costs required to comply with these new regulations.

Actors were required to comply with ONC's information blocking regulations starting April 5, 2021. To help meet the new requirements, the AMA has created a two-part educational resource to help physicians and their medical practices understand the requirements and develop an information blocking compliance program.

  • Part 1 outlines what information blocking is, key terms to know, examples of information blocking practices and a summary of exceptions for when physicians may restrict the access, exchange or use of EHI.
  • Part 2 will help physicians start on the path of compliance, including questions to consider, considerations for maintaining a compliance program and next steps.

The new rules also regulate EHR vendors and restrict them from blocking information. EHR vendors are prohibited from blocking physicians’ access, exchange, or use of medical information through contractual, technical, or financial limitations. This could include, but not limited to, excessive fees charged by the vendor to connect to the local HIE, contracts limiting physicians’ ability to send information to a clinical data registry, or implementing proprietary technology in a way that prevents physicians from exporting reports, connecting to diagnostic facilities, or switching EHR vendor products. Like all Actors, EHR vendors must comply with these regulations by April 5. Information blocking not only affects patients but also physicians; the AMA encourages physicians to reach out to their EHR vendor to discuss what they are doing to come into compliance. 

As the federal government releases new guidance, the AMA and we at the AMCNO will continue to update these resources.  

Here are additional resources to help navigate the regulations: