ACOs and physician group call for removal of financial penalties in information blocking rule

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The National Association of ACOs is asking for changes to the information blocking rule prohibiting participation in the Medicare Shared Savings Program if the ACO or its clinicians for noncompliance.

NAACOS submitted a letter to Micky Tripathi, national coordinator for Health Information Technology at the Office of the National Coordinator, and Chiquita Brooks-LaSure, administrator for the Centers for Medicare and Medicaid Services, on January 2, the deadline to submit comments on the proposed rule.

Prohibiting ACO participation as a penalty for information blocking penalizes patients by blocking participation in value-based models aimed at improving patient care, NAACOS said. It advises CMS and the ONC to apply a corrective action plan for information blocking, rather than imposing financial penalties.

CMS should avoid double penalizing healthcare providers found to have committed information blocking by removing penalties that impact MSSP participation, NAACOS said. NAACOS recommends CMS and the ONC only apply fines at the individual clinician/group levels, rather than the ACO entity. 

CMS should focus on establishing an educational campaign to increase awareness among providers regarding what constitutes information blocking. It should more clearly outline the appeals rights of ACOs and the clinicians in an ACO, and align that to what is afforded to health IT developers and vendors, NAACOS said.

WHY THIS MATTERS

MGMA, the Medical Group Management Association, also submitted feedback on the proposed rulemaking on Tuesday, with its comments echoing many of the same recommendations as NAACOS. 

"While we recognize the need for ONC and CMS to establish appropriate disincentives, we harbor significant concerns with the proposed rule and its impact on medical groups," MGMA said. 

MGMA also recommends that a corrective action plan be implemented instead of levying what it called "significant" financial penalties and called for a "straightforward appeals process."

MGMA indicated that as the rule stands, providers would have incentive to stop participating in Medicare. 

"A corrective action process that allows for providers to rectify offending conduct would most efficiently promote interoperability without dissuading providers from participating in Medicare due to severe financial disincentives," MGMA said. 

The association recommends removal of the stipulation that ACOs and participating providers found to be noncompliant not be allowed to be in the MSSP. 

It also wants CMS and the ONC to remove punitive disincentives for providers participating in the Merit-based Incentive Payment System or MIPS by zeroing out the promoting interoperability category.

"The substantial administrative burden and difficulties medical groups face under the MIPS program will be exacerbated should the agencies move forward with this penalty," MGMA said.

THE LARGER TREND

On November 1, the ONC and CMS issued the proposed rule implementing disincentives for information blocking under the Promoting Interoperability Program. 

The rule would apply financial disincentives to healthcare providers and hospitals for information blocking.

Disincentives were also issued for eligible clinicians under MIPS and ACO participants in the Medicare Shared Savings Program.

The Office of Inspector General would be empowered to respond to information blocking complaints to determine whether healthcare organizations "knowingly and unreasonably" interfered with access, exchange or use of electronic health information.

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org