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Federal Register / Vol 7610 Federal Register / Vol. 84, No. 42 / Monday, March 4, 2019 / Proposed Rules reference information, clinical guidelines, DEPARTMENT OF HEALTH AND CMS–9115–P, P.O. Box 8016, Baltimore, condition-specific order sets, alerts, and HUMAN SERVICES MD 21244–8016. reminders, among other tools. Please allow sufficient time for mailed • Clinical Quality Measures criteria for Centers for Medicare & Medicaid comments to be received before the record and export, import and calculate, and Services close of the comment period. filter criteria: 3. By express or overnight mail. You Æ Record and export criterion ensures that 42 CFR Parts 406, 407, 422, 423, 431, may send written comments to the health IT systems can record and export 438, 457, 482, and 485 following address ONLY: Centers for CQM data electronically; the export Medicare & Medicaid Services, functionality gives clinicians the ability to Office of the Secretary Department of Health and Human export their results to multiple programs. Services, Attention: CMS–9115–P, Mail Æ import and calculate criterion supports 45 CFR Part 156 Stop C4–26–05, 7500 Security streamlined clinician processes through the Boulevard, Baltimore, MD 21244–1850. importing of CQM data in a standardized [CMS–9115–P] For information on viewing public format and ensures that health IT systems comments, see the beginning of the can correctly calculate eCQM results using a RIN 0938–AT79 SUPPLEMENTARY INFORMATION section. standardized format. FOR FURTHER INFORMATION CONTACT: Æ filter criterion supports the capability for Medicare and Medicaid Programs; Patient Protection and Affordable Care Alexandra Mugge, (410) 786–4457, for a clinician to make a query for eCQM results issues related to interoperability, CMS using or a combination of data captured by Act; Interoperability and Patient Access for Medicare Advantage health IT strategy, technical standards the certified health IT for quality and patient matching. improvement and quality reporting purposes. Organization and Medicaid Managed Care Plans, State Medicaid Agencies, Natalie Albright, (410) 786–1671, for Alignment With Proposed New or Updated CHIP Agencies and CHIP Managed issues related to Medicare Advantage. John Giles, (410) 786–1255, for issues Certification Criteria Care Entities, Issuers of Qualified related to Medicaid. ONC believes this recommendation is Health Plans in the Federally- Emily Pedneau, (301) 492–4448, for supported by the proposed new and updated Facilitated Exchanges and Health Care issues related to Qualified Health Plans. certification criteria in this proposed rule: Providers Meg Barry, (410) 786–1536, for issues • United States Core Data for related to CHIP. Interoperability (USCDI): The USCDI AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. Thomas Novak, (202) 322–7235, for (§ 170.213) which enables the inclusion of issues related to trust exchange pediatric vital sign data elements, including ACTION: Proposed rule. networks and payer to payer the reference range/scale or growth curve for SUMMARY: This proposed rule is coordination. BMI percentile per age and sex, weight for Sharon Donovan, (410) 786–9187, for age per length and sex, and head occipital- intended to move the health care issues related to federal-state data frontal circumference. ecosystem in the direction of • interoperability, and to signal our exchange. Application Programming Interfaces Daniel Riner, (410) 786–0237, for (APIs): § 170.315(g)(10), would require the commitment to the vision set out in the ® 21st Century Cures Act and Executive issues related to Physician Compare. use of Health Level 7 (HL7 ) Fast Healthcare Ashley Hain, (410) 786–7603, for ® Order 13813 to improve access to, and Interoperability Resources (FHIR ) standards issues related to hospital public and several implementation specifications to the quality of, information that Americans need to make informed reporting. establish standardized application Melissa Singer, (410) 786–0365, for health care decisions, including data programming interfaces (APIs) for issues related to provider directories. interoperability purposes and to permit 3rd about health care prices and outcomes, CAPT Scott Cooper, USPHS, (410) party software developers to connect to the while minimizing reporting burdens on 786–9465, for issues related to hospital electronic health record (EHR) through the affected plans, health care providers, or and critical access hospital conditions certified API technology. payers. of participation. [FR Doc. 2019–02224 Filed 2–22–19; 4:15 pm] DATES: To be assured consideration, Lisa Bari, (410) 786–0087, for issues BILLING CODE 4150–45–P comments must be received at one of related to advancing interoperability in the addresses provided below, no later innovative models. than 5 p.m. on May 3, 2019. Russell Hendel, (410) 786–0329, for ADDRESSES: In commenting, please refer issues related to the Collection of to file code CMS–9115–P. Because of Information or the Regulation Impact staff and resource limitations, we cannot Analysis sections. accept comments by facsimile (FAX) SUPPLEMENTARY INFORMATION: transmission. Inspection of Public Comments: All Comments, including mass comment comments received before the close of submissions, must be submitted in one the comment period are available for of the following three ways (please viewing by the public, including any choose only one of the ways listed): personally identifiable or confidential 1. Electronically. You may submit business information that is included in electronic comments on this regulation a comment. We post all comments to http://www.regulations.gov. Follow received before the close of the the ‘‘Submit a comment’’ instructions. comment period on the following 2. By regular mail. You may mail website as soon as possible after they written comments to the following have been received: http:// address ONLY: Centers for Medicare & www.regulations.gov. Follow the search Medicaid Services, Department of instructions on that website to view Health and Human Services, Attention: public comments. VerDate Sep<11>2014 19:17 Mar 01, 2019 Jkt 247001 PO 00000 Frm 00188 Fmt 4701 Sfmt 4702 E:\FR\FM\04MRP2.SGM 04MRP2 Federal Register / Vol. 84, No. 42 / Monday, March 4, 2019 / Proposed Rules 7611 I. Background and Summary of health information in interoperable providers and are taking an active Provisions forms. Patients and the health care approach using all available policy providers caring for them are often levers and authorities to move A. Purpose presented with an incomplete picture of participants in the health care market This proposed rule is the first phase their health and care as pieces of their toward interoperability and the secure of proposed policies centrally focused information are stored in various, and timely exchange of health care on advancing interoperability and unconnected systems and do not information. patient access to health information accompany the patient to every care using the authority available to the setting. C. Executive Order and MyHealthEData Centers for Medicare & Medicaid We believe patients should have the On October 12, 2017, President Services (CMS). We believe this is an ability to move from health plan to Trump issued Executive Order 13813 to important step in advancing health plan, provider to provider, and Promote Healthcare Choice and interoperability, putting patients at the have both their clinical and Competition Across the United States. center of their health care and ensuring administrative information travel with Section 1(c)(iii) of Executive Order they have access to their health them throughout their journey. When a 13813 states that the Administration information. We are committed to patient receives care from a new will improve access to, and the quality solving the issue of interoperability and provider, a complete record of their of, information that Americans need to achieving complete access to health health information should be readily make informed health care decisions, information for patients in the United available to that care provider, including information about health care States (U.S.) health care system, and are regardless of where or by who care was prices and outcomes, while minimizing taking an active approach to move previously provided. When a patient is reporting burdens on affected plans, participants in the health care market discharged from a hospital to a post- providers, and payers. toward interoperability and the secure acute care (PAC) setting there should be In support of Executive Order 13813, and timely exchange of health no question as to how, when, or where the Administration launched the information by proposing and adopting their data will be exchanged. Likewise, MyHealthEData initiative. This policies for the Medicare and Medicaid when an enrollee changes health plans government-wide initiative aims to programs, the Children’s Health or ages into Medicare, the enrollee empower patients by ensuring that they Insurance Program (CHIP), and issuers should be able to have their claims have full access to their own health of qualified health plans (QHPs). history and encounter data follow so Throughout this proposed rule, we information and the ability to decide that information is not lost. how their data will be used, while refer to terms such as patient, consumer, For providers in clinical settings, keeping that information safe and beneficiary, enrollee, and individual. health information technology (health secure. MyHealthEData
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