New CMS Office – Will Burden Reduction or Health Informatics Be the Real Focus?

by Beth Anne Jackson, J.D.

On June 23, 2020, the Centers for Medicare and Medicaid Services (“CMS”) announced the creation of the Office of Burden Reduction and Health Informatics (the “OBRHI”). OBRHI serves two purposes: it centralizes CMS’s efforts to reduce regulatory and administrative burden on providers and to actualize the potential of data-driven health care.

In 2017, following President Trump’s so-called “Cut the Red Tape” executive order, CMS conducted a comprehensive review of health and standards and regulations after provider and supplier types were deemed eligible to receive reimbursement under the Medicare program. In addition, CMS sought the input of more than 2,500 providers, clinicians and other health care stakeholders through 158 site visits and listening sessions and10 Requests for Information combined with interviews, resulting in 15,000 comments. A final rule, sometimes referred to as the “Omnibus Burden Reduction (Conditions of Participation) Final Rule CMS-3346-F, was issued on September 26, 2019. The burden reductions in the rule include little directly for physicians. Indirect reductions include allowing multi-hospital systems to have system-wide quality assurance/performance improvement, infection control and antibiotic stewardship programs (requiring fewer physicians to serve on these committees). CMS’s efforts are expected to save 42 million “unnecessary” burden hours and $6.6 billion for providers and suppliers.

The health informatics functions of OBRHI will seek to maximize the efficiencies to be gained from the implementation of the interoperability and patient access provisions of the bipartisan 21st Century Cures Act (“Cures Act”). HHS Office of the National Coordinator for Health Information Technology (ONC) and CMS published final rules implementing the Cures Act in March 2020. Much of these rules affect federal health care programs which must provide access to claims data through beneficiaries’ choice of Application Programming Interface (“API”), and tech developers, who must not block the flow of electronic health information and must make certain data elements transmissible via ONC-approved technology standards. Nevertheless, the CMS rule does impose some requirements directly on providers: hospitals will be required to send admission, discharge, and transfer data to patients’ community-based physician, facilitating follow-up care. The rules also provide for physicians’ answers to questions regarding whether the physician/physician practice blocks interoperability to be posted on the Physician Compare site.

The creation of OBRHI is a recognition by CMS that in order for the Cures Act and other promises of data-driven health care to be realized, there must be a “one-stop shop” for all stakeholders, including physicians–especially physicians on whom the burden of creating health care data largely rests. Make your voice heard.

DISCLAIMER: This article is for informational purposes only and does not constitute legal advice. You should contact your attorney to obtain advice with respect to your specific issue or problem.

Beth Anne Jackson is a shareholder in the Health Care Practice Group of Brown & Fortunato, P.C., which is headquartered in Amarillo, Texas and serves health care providers nationally. She is licensed in both Pennsylvania and Texas and maintains an office in the greater Pittsburgh area. She may be reached locally at 724-413-5414 or by email at bjackson@bf-law.com. Her firm’s website is www.bf-law.com.