With the creation of new technologies, new partnerships, and expanded health programming, information sharing within the world of health care has never been more crucial. This brings up many new opportunities for convenience, streamlined processes, and better continuity of care. However, it also presents challenges for providers and information security professionals who must limit health data sharing to relevant parties.

Government bodies have entered countless discussions over the past 5 years to adopt legislation that aids with the protection of patient information. One such law is the 21st Century Cures Act, more commonly known as the Information Blocking Rule. This was initially adopted in 2016 and was meant as a broad way to allow a range of parties (from health care agencies to patients and individual providers) to access health information.

Since this law is meant to protect information, the legislation did note eight specific exceptions that are not considered information blocking. These exceptions were added to the legislation in 2021, and include:

  • Issuance of fees
  • Not fulfilling data requests if they interfere with a patient’s safety
  • Provision of licenses to access data
  • Limitation of health information provided (which complies with HIPAA’s “minimum necessary” standard)
  • Not fulfilling data requests if they breach a patient’s privacy
  • Denying an infeasible information request
  • Not fulfilling data requests in the event they cause patient harm
  • Performance of typical health-related information technology services

This legislation was revised again, an amendment that will go into effect in October 2022, to state that requests for health information should be fulfilled in the format they are requested, such as digitally or physically. If it’s not possible to execute the request in this way, both parties should come to an agreement about an alternate manner of fulfillment.

While providers and health entities might find related policies and procedures inconvenient, information blocking was developed to preserve the best interest of the patient. When patients feel more comfortable with managing their data, they develop more trust and confidence in health care organizations, insurers, and other parties involved in their care.

Information blocking is just one of a multitude of requirements involved with maintaining an adequate provider network. If your provider network needs a health check, reach out to TOG Network Solutions today to learn more about how our services can minimize corrective burdens and maximize payment integrity.