March 18, 2022

Maverick's Update

Only What Matters In Health Information Policy

March is an odd time of year, with Chicago making its river green on purpose, the Senate trying to make Daylight Savings Time an all-the-time thing, and the weather unable to commit to winter or spring. This year is particularly whacky if you’re interested in health policy and health information technology, because it means you’re tracking both the AHIP Policy Conference and the HIMSS Conference -- and this is the same week that most people are on spring break. Must be fun for the spring breakers to compete for seats at Orlando, Florida restaurants with the ~26,000 people at HIMSS. It is from HIMSS that we got our weird March news for the One Thoughtful Paragraph below.

News about how some people are celebrating spring:

• Sunnier days for prior authorization are coming. Both CIGNA and Guidewell have made moves to create an electronic prior authorization system. Late last week, the ONC federal advisory committee (“HITAC”) released its recommendations to explain how the federal government could require health plans and providers to exchange information through an electronic prior authorization process.

• Winter hibernation is over for the No Surprises Act. The American Hospital Association says providers need automated solutions to create the “good faith estimates” of patient charges as fast as the No Surprises Act requires. The Medical Group Management Association (MGMA) and the Workgroup for Electronic Data Interchange (WEDI) agreed that providers are not ready to implement the NSA requirements, but were not as explicit about the need for automation.

• The modern public health data infrastructure is about to blossom. Congress just approved $100 million to modernize public health data and analytics at the CDC. At HIMSS, CDC and ONC officials talked about their collaboration to improve public health data interoperability and modernization, including streamlining electronic lab data from state health departments to the CDC. Seems like the FHIR-enabled US Laboratory Report emerging standard is coming... foreshadowed in January by ONC here.

One Thoughtful Paragraph

When HHS Secretary Xavier Becerra told HIMSS attendees that his agency is “closing the enforcement gap” on the 21st Century Cures rule “later this year” by establishing financial penalties against providers who unnecessarily block healthcare information -- it reminded us of a scene in a movie. In 1993, during the whacky month of March, the fabulous actress Marisa Tomei won best supporting actress for her role in the comedy My Cousin Vinny. If you watch her most famous scene, you can see why she won (and why the film is still talked about to this day). As the long-time girlfriend of the noncommittal Vinny (Joe Pesci), she confronts him about their forever-delayed wedding plans saying “My niece, the daughter of my sister, is getting married”—and bangs her high-heeled-boot-clad foot that satisfyingly echoes against the hard wood of a cabin porch to illustrate how her “biological clock is ticking like this.” We understand her impatience. The information blocking penalty clock has been ticking since April 24, 2020, when the HHS Office of Inspector General published its proposed rule to impose civil monetary penalties on entities who improperly block healthcare information. And enforcement is coming more than two years later? Marisa Tomei could have had two babies by now.