Healthcare Compliance Newsletter – Winter 2021

Healthcare Compliance Newsletter – Winter 2021 600 444 Drummond Group
In this issue:
  1. Transform Secure Data Exchange with FHIR® API Certification Test
  2. State Requires Long-Term Care Facilities to Use ONC-Certified EHR Technology
  3. It’s Simple: Schedule a Pre-Test Practice Session
  4. New Rates, More Flexibility
Transform Secure Data Exchange with FHIR® API Certification Test

Launched in Fall 2020, Drummond’s Payer and Patient Access FHIR® Certification Program is enabled to provide a transformative path to seamless, collaborative data exchange across entire healthcare ecosystems. Developers and payers will benefit from our HL7 FHIR® API certification test – powered by the AEGIS Touchstone platform – designed to address compliance to the Centers for Medicaid and Medicaid Services (CMS) Interoperability and Patient Access final rule (CMS-9115-F) as the first step to putting patients first and facilitating access to their health information.

Building on that final rule (CMS-9115-F), CMS-9123-P places new requirements on Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs, and Qualified Health Plans (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of health care data, and streamline processes related to prior authorization. The end goal is to reduce overall payer and provider burden as well as improve patient access to health information by adopting HL7’s FHIR® based standards for electronic data sharing.

Drummond and AEGIS (a recognized convening and technology provider in the HL7® ecosystem) are prepared to fill the interoperability gap and extend a valuable certification service to the payer software community. This service will ensure that payer implementations of patient access and payer exchange APIs remain compliant with both rules, as well as instill confidence in the ability to securely share data with patients and other payers. Some of the benefits related to Drummond’s Payer and Patient Access FHIR® Certification Program include:

  • A premier and robust Touchstone® platform to validate conformance with the FHIR standard and required use case
  • A trusted and experienced test lab to enable streamlined and consistent testing
  • A certification seal and publicly available list distinguishing those that have successfully achieved certification, providing greater assurance to the market
  • A mechanism for ongoing, in-the-field surveillance of conformance to complement regulatory enforcement
  • A predictable renewal cycle to ensure updates to the standard are implemented by certified payers and systems

Learn more about the various certification options and to become more familiar with what is required of payers and the application developers supporting them, or email: FHIR@drummondgroup.com

See related FAQs here. Or contact us to register for Drummond’s FHIR® API certification test today!

State Requires Long-Term Care Facilities to Use ONC-Certified EHR Technology

While federal law has been a significant motivator in the adoption of ONC certified electronic health records (EHR) technology (CEHRT), some states are beginning to increase efforts requiring the use of certified technology as part of their own programs.

One example of state-specific legislation is New Jersey Assembly Bill 4476 approved in September 2020. This bill establishes certain requirements concerning the state’s preparedness and response to infectious disease outbreaks, including COVID-19. As part of the preparedness efforts, the bill requires long-term care (LTC) facilities to implement or upgrade to ONC certified EHR technology that includes interoperability capabilities. LTC facilities will need to use interoperable capabilities to connect to the New Jersey Health Information Network.

P.L. 2020, CHAPTER 87, Assembly, No. 4476 states as follows:

6. (New Section) a. No later than 270 days after the effective date of this act, each long-term care facility shall implement or upgrade to an electronic health record system certified by the Office of the National Coordinator for Health Information Technology in the U.S. Department of Health and Human Services that is capable of information sharing through industry standard data interoperability, including application programming interface Health Level 7 or fast healthcare interoperability technology. Use cases built on this technology shall include the bi-directional capability for admission discharge and transfer and continuity of care through the clinical data architecture. Long-term care facilities interoperability for these use cases shall be achieved by connecting to the New Jersey Health Information Network.

This New Jersey bill represents a likely trend in state-specific legislation to require use of CEHRT and interoperability capabilities as part of state public health initiatives. We encourage Health IT Developers to consider the various programs in which their customers may seek to participate both for federal programs and state-specific requirements and start the testing and certification process well in advance of the deadlines.

To start becoming familiar with the ONC Health IT program and to connect with a Drummond team member for an overview, download our Decision Guide to 2015 Edition here.

It’s Simple: Schedule a Pre-Test Practice Session

Drummond is aware the ONC’s 21st Century Cures updates for the 2015 Edition of health IT software can be daunting, so we’ve got you covered! For our health IT developer clients who have yet to complete their 2015 Edition certification, Drummond continues to offer pre-test practice sessions with a test proctor to supplement your certification testing preparation strategy. Scheduling a pre-test session is simple: contact your Drummond Account Manager.

We also extend this service to our health IT developer customers already certified to the 2015 Edition interested in attesting their own respective implementation of the ONC’s 21st Century Cures updates for e-prescribing, USCDI, CQM CMS Implementation Guide and other required upgrades. Drummond’s pre-test sessions may be utilized to gain some independent eyes on your implementation ahead of making your formal attestations of compliance to your ONC -Authorized Certification Body. Contact Drummond if you are interested in scheduling a pre-test session for any of your Cures updates.

New Rates, More Flexibility

Drummond’s 2021 rates provide clients additional flexibility and control over the services needed based on the scope of readiness for each test event. This added flexibility gives clients the chance to manage valuable time and resources more efficiently. Just ask us – get answers today!

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