A Florida hospital was hit this month with the first fine by the Department of Health and Human Services (HHS) for information blocking after it took too long to fulfill a patient’s record request.
Bayfront Health St. Petersburg has to pay the Office of Civil Rights $85,000 for failing to give a mom timely access to the prenatal records she requested for her child. HHS received a complaint from the woman that she waited nine months for her records.
The complaint launched an HHS investigation.
“The HIPAA rules generally require covered healthcare providers to provide medical records within 30 days of the request and providers can only charge a reasonable, cost-based fee,” HHS said in a release quoted by FierceHealthCare.
Bayfront, a 480-bed hospital, also implemented a corrective action plan that includes monitoring from the OCR for one year.
Moves to end information blocking
HHS released a proposed rule in February that outlines fines for information blocking. The rule is required by the 21st Century Cures Act, signed into law in 2016. The Cures Act was created to prevent information blocking.
HHS is proposing in its rule, which isn’t yet finalized, that violators could pay as much as $1 million per infraction. The agency also wants to “name and shame” hospital physicians that block information by listing offenders on the Physician Compare website.
Information blocking is defined as a practice “by a health care provider, health IT developer, health information exchange, or health information network that, except as required by law or specified by the Secretary of Health and Human Services as a reasonable and necessary activity, is likely to interfere with, prevent or materially discourage access, exchange or use of electronic health information (EHI).”
Several practices can be considered information blocking, such as:
- restricting access, exchange or use of information for treatment or other permitted purposes
- implementing health technology in nonstandard ways that are likely to increase the burden or complexity of using EHI
- implementing health technology that’s likely to restrict access or fail to export complete information sets, and
- fraud, waste or abuse or impeding innovations or advancements in health information access, exchange and use.
The Office of the National Coordinator for Health Information Technology (ONC) also lists these practices as examples of information blocking:
- Imposing formal or information restrictions on access, exchange or use of EHI
- Limiting the timeliness of access, exchange or use of EHI
- Imposing terms or conditions that discourage the use of interoperability elements in electronic health records (EHR) systems
- Exercising influence over customers, users or others to develop or use interoperable technologies
- Discriminatory practices that frustrate or discourage efforts to enable interoperability, and
- Rent-seeking or opportunistic pricing practices.
In the case of the St. Petersburg hospital, the timeliness of access and use of the woman’s prenatal care records was violated under ONC rules.
Hospitals of all sizes must stay current with proposed rules from ONC as they are made available. Here are some best practices to follow:
- Hospital IT staff should quickly investigate any information access issues that arise so medical records are always readily available to patients.
- Start the clock on any medical records request so the information is delivered in the 30- day window required by the law, leaving time to address any electronic glitches that could impact access to the information.
- Make sure the price structure for medical records is reasonable and cost-based, as required by HHS. Fees should be based on costs to the hospital, but not so expensive that patients find it prohibitive to request records.