Several major provider groups continued to push back against pending final rules on data blocking and interoperability.
In a letter to Senate and House leaders, the groups—including the American Health Information Management Association, the American Medical Association and the College of Healthcare Information Management Executives—called on the federal government to release interim rulemaking, which they claimed will allow agencies to address a slew of industry concerns.
Interim rulemaking would also reopen a proposed rule from the Office of the National Coordinator for Health Information Technology for further comment from stakeholders.
An ONC spokesperson said the agency is aware of the letters. They did not comment on whether the ONC has plans for supplemental rulemaking.
"We are mindful of the need to balance concerns of incumbent stakeholders with the rights of patients to have transparency and actionable choice in their healthcare," the agency spokesperson said.
The ONC's proposed rule on information-blocking—a companion to the CMS' interoperability proposal, both released in February—outlines how regulators will require providers to share medical data with patients, as well as steps to discourage healthcare organizations from creating barriers that stand in the way of health data exchange.
While the seven groups said they support many of the provisions in the ONC's information-blocking rule, such as proposals related to use of application programming interfaces and certification of electronic health record systems, they argued that interim rulemaking would help to clarify aspects of the rule that are complex or confusing.
Even foundational aspects of the ONC's proposal, such as its exceptions for when information-blocking is acceptable, are too broad and may cause confusion, the groups wrote.
"To ensure a sufficient level of industry review and to appropriately respond to stakeholder feedback, ONC should issue a supplemental rulemaking to address outstanding questions and concerns," the letter states.
The groups urged the Senate Health, Education, Labor and Pensions Committee and the House Energy and Commerce Committee to use their oversight of the 21st Century Cures Act to address their concerns for the information-blocking proposal, which was mandated by the Cures Act.
They aren't the first to request additional rulemaking. In June, the American Hospital Association said it "strongly recommend(ed)" that the ONC release an interim final rule and provide hospitals with at least 18 months to set up systems as required under the information-blocking provisions, raising concerns that having these provisions go into effect the day the rule is finalized won’t provide hospitals with enough time for implementation. And the Alliance of Community Health Plans earlier this year suggested the CMS issue an interim rule for its interoperability proposal to clarify what data payers will be required to share with patients via APIs and how the mandate will be enforced.
The Health Innovation Alliance has called on both the ONC and the CMS to rescind their rules entirely, and instead reissue them as separate, smaller proposals.
In addition to supplemental rulemaking, the seven groups also requested additional privacy and security provisions; longer implementation timelines; and "discretion" in the ONC's initial enforcement of the information-blocking provisions—that means HHS should prioritize education and corrective action plans over monetary penalties, they urged.
"Prioritizing education will be more effective over the long-term in ensuring clinicians, hospitals and health information professionals are in compliance as they will better understand the regulatory requirements," the groups wrote.