FAQ #9 - Enforcement of HHS Interoperability Rules

Healthcare Interoperability FAQ Series

FAQ #9: How will the new HHS interoperability rules for providers and payers be enforced?


The HHS or Health and Human Service, interoperability rules for providers, payers, and EHR vendors are pretty complex. Interoperability, although it’s been a long time coming and discussed for a long time, this is the first time that the rule has come into place. The ONC’s final rule has come into place and it’s going to happen.
The first stage is to absorb what that actually means. Well, it means it’s going to happen, but the requirements are complex. And so, there’s really a need to educate each of these players in the field in terms of what the rule means. How do you become compliant with the rule?
The first milestone, which is as of April 2021, is that there can’t be any information blocking. It is, by and large, targeted towards the EHR or EMR vendors because those vendors have been largely behind the fact that there is very little cooperation. There are all these silos of health information about patient. Patients must be able to access their own information, and that is what the rule is fundamentally based on. It is making sure that patients can access their health information regardless of what or how many systems there are. And so, everybody’s on the hook for making sure that they meet these requirements.
The enforcement rules are not entirely clear right now. But the trend has always been that they will be punitive financially. Really, what hurts is the bottom line for any company. Each of our vendors will pay attention to that. Since the rule has now been in effect, the vendors have moved forward. What they've been doing for the past decade or so is effectively blocking this kind of rule, largely for business reasons. They answer to the shareholders. They might give lip service to the idea that they’re wanting to develop interoperability among systems to improve care coordination and the outcomes of patients.
But the truth is that it’s not their number one priority, and that’s based on business, revenues, and shareholder expectations. This rule really solves that challenge.
The second part of the rule is the enforcement of the full implementation of interoperability towards the end of December 2022. And again, the enforcement rules and penalties around that have not been finalized, but those are likely to be punitive in some form as well.


Dr. Ralph Tarter

Dr. Weatherbee has spent decades working in education, behavioral health, public health, and more. He has experienced the unique challenges that exist in this field from multiple disciplines. His work in program evaluation lead him to create eINSIGHT to empower behavioral health service providers to improve client outcomes.