It may not be Independence Day yet, but for health plans, July 1st could be called Enforcement Day — the day the federal government can begin enforcing the Interoperability and Patient Access final rule. It is a big deal to think that people can ask their health plans to download their health information onto the app of their choice — anytime, anywhere, for free. Maybe celebrating with fireworks is appropriate for July 1st too — or, if you’re in charge of operationalizing the interoperability rule at a health plan, maybe a different type of explosion is in order.
When you track health information technology issues like Maverick does, you review sources of news like RACMonitor — a publication about third party contract auditor activity to help healthcare providers understand their business risks. They had an interesting tidbit yesterday about how the same enormous piece of legislation (passed and signed into law in 2020) that included the No Surprises Act (a bill that prohibits providers from surprise-balance billing people for medical services) also required U.S. intelligence agencies to release a report about UFOs. Remember, in the movie Independence Day, the President didn’t know that there was an alien spaceship and preserved alien species in Area 51 — but the CIA knew. So now our truth may be stranger than fiction… and while the UFO report is arguably more interesting … we need to acknowledge the enormous regulatory undertaking beginning today for health plans. Not only are they supposed to have interoperable claims and clinical data ready to go to any third party app, and very updated and accurate provider directories, but plans are also expecting new rules (maybe today) that will implement the No Surprises Act. Plans are anticipating new mandates for Advanced Explanation of Benefits (so people can know how much medical services cost BEFORE they get them) and price comparison tools (so people can compare healthcare prices). We may be on the right track to making more information available, but it will take a while to get these great ideas into a simplified and seamless format so people can actually use all this amazing digital health information. Like the Will Smith character says in the movie Independence Day, “It ain’t over until the fat lady sings.”