CMS Releases COVID-19 Interim Final Rule; ONC Delays Interoperability Requirements

Over the last week, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) have released two interim final rules pertaining to COVID-19 and information blocking/interoperability enforcement. ACC Advocacy staff are in the process of reviewing both rules to better understand their scope and impact on cardiology, and to provide comments as necessary.

COVID-19 Interim Final Rule

On Oct. 28, CMS issued an fourth COVID-19 interim final rule with comment period containing information on COVID-19 vaccine administration and costs for beneficiaries, state innovation waivers during the public health emergency, enhanced payments for COVID-19 treatments, and price transparency for COVID-19 diagnostic tests.

The rule adds a U.S. Food and Drug Administration authorized or approved COVID-19 vaccine and its administration to the list of preventable vaccines covered under Medicare Part B without coinsurance or deductible. The rule also states CMS and the American Medical Association are working on developing vaccine-specific codes to bill for and track different vaccine use. Further, the rule requires Medicaid, Children's Health Insurance Program agencies, and most private health plans to administer the vaccine at no cost to patients during the public health emergency.

The rules creates add-on payments in the inpatient and outpatient settings for COVID-19 therapeutics, and requires clinicians who perform COVID-19 diagnostic tests to post their cash prices online via their website.

Information Blocking and Interoperability Enforcement

Earlier this year, due to the COVID-19 public health emergency, ONC announced a three-month extension of compliance for provisions in the 21st Century Cures Act Interoperability and Information Blocking final rules. Due to the continued public health emergency, ONC has extended compliance and applicability dates for provisions in the final rule including the information blocking provisions, certain 2015 edition health information technology certification criteria, and conditions and maintenance of certification requirements under the ONC Health IT Certification Program.

New key dates include:

  • April 5, 2021 – Information blocking provisions
  • Dec. 31, 2022 – 2015 electronic health record certification criteria update and new standardized application programing interface functionality

These extensions change the dates provisions go into effect and push back the compliance timeline for vendors and organizations. While providers are not required to share electronic health information until April 5, 2021, organizations are encouraged to continue to develop processes to allow for information sharing. Read a FAQ here.

Keywords: ACC Advocacy, Coronavirus, severe acute respiratory syndrome coronavirus 2, COVID-19, Medicaid, Centers for Medicare and Medicaid Services (U.S.), Deductibles and Coinsurance, American Medical Association, Electronic Health Records, United States Food and Drug Administration


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