On June 27, 2023, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued its long-anticipated final rule amending the OIG’s civil monetary penalty (CMP) regulations as they relate to information blocking (CMP Final Rule or Rule). The CMP Final Rule was published in the Federal Register on July 3, 2023. The Rule applies to entities that develop or offer certified health IT (collectively, Developers) and health information networks and health information exchanges (collectively, HIN/HIEs). Those subject to the CMP Final Rule should consider prioritizing their compliance efforts because the OIG will begin enforcing the Rule on September 1, 2023. Below we discuss the applicability of the CMP Final Rule, the assessment of penalties under the Rule, and the OIG’s enforcement priorities moving forward.
In 2016, the 21st Century Cures Act (Cures Act) made sharing electronic health information (EHI) the new normal in healthcare, with the twin goals of encouraging and incentivizing the free flow of patient information among stakeholders and driving efficiencies in healthcare. The Cures Act authorized the Secretary of HHS to identify “reasonable and necessary activities that do not constitute information blocking.”[1] The Cures Act defined conduct that constitutes “information blocking,” i.e., a practice by an “actor” that, except as required by law or specified in an information blocking exception, is likely to...
An Appleton clinic and its founder agreed to pay $175,000 to settle allegations that the clinic falsely submitted claims to Medicare for electrical muscle stimulation and vitamin injections, accord...