CMS Issues Guidance on Information Blocking Prevention in MIPS

November 2017 ~

CMS has published guidelines detailing requirements as to how Merit-Based Incentive Payment System (MIPS)-eligible clinicians must attest in order to prove they have made a “good-faith” effort to implement and use electronic health records (HER) technology that supports the timely exchange of healthcare information in order to receive quality payments under MACRA.

Under the new guidance, CMS will require MIPS-eligible clinicians to complete a “Prevention of Information Blocking Attestation” to receive a score for advancing care information performance under the Quality Payment Program.

According to a CMS fact sheet, clinicians who have elected to report under MACRA’s Merit-based Incentive Payment System (MIPS) will be required to attest that they have not “knowingly and willfully limited or restricted the compatibility or interoperability” of certified EHR technology (CEHRT).

This attestation includes three related statements that are based on section 106(b)(2) of the MACRA about how MIPS eligible clinicians implement and use CEHRT. As stated in the fact sheet, when a clinician attests to these three statements together, they are confirming that they have acted in good faith to “support the appropriate exchange of electronic health information” and “not knowingly and willfully limit or restrict the compatibility or interoperability of the CEHRT.”

Statement 1: “A MIPS eligible clinician must attest that they did not knowingly and willfully take action (such as to disable functionality) to limit or restrict the compatibility or interoperability of CEHRT”

Statement 2: “A MIPS eligible clinician must attest that they implemented technologies, standards, policies, practices, and agreements reasonably calculated to ensure, to the greatest extent practicable and permitted by law, that the CEHRT was, at all relevant times”

Statement 3: “A MIPS eligible clinician must attest that they responded in good faith and in a timely manner to requests to retrieve or exchange electronic health information, including from patients, health care providers (as defined by 42 U.S.C. 300jj(3)), and other persons, regardless of the requestor’s affiliation or technology vendor”

In addition to the Prevention of Information Blocking Attestation, clinicians are required to meet the following requirements to earn a score in the advancing care information performance category:

  • Use CEHRT
  • Submit a performance period
  • Attest to work in good faith with an ONC direct review, if requested to assist in an ONC direct review
  • Meet all the base score measure requirements

Clinicians who receive a request for surveillance can also choose to attest to work in good faith with an ONC–ACB surveillance of their health information technology if it is certified under the ONC Health IT Certification Program.

CMS notes clinicians are not required to provide any documentation to show they have acted in good faith to: implement and use CEHRT to support the appropriate exchange of electronic health information or not block information.

For full details regarding the Information Blocking Attestation, refer to the MIPS Advancing Care Information Prevention of Information Blocking Attestation Fact Sheet and more information about the requirements for the MIPS and APMs can be found on the CMS Quality Payment Program website.

Source(s): CMS; FierceHealthcare; EHRIntelligence; Healthcare Informatics; HealthcareDIVE;