MGMA Recommends Use of Corrective Action Plans for Information Blockers

Jan. 3, 2024
Medical Group Management Association also said it would be a mistake to institute punitive disincentives for providers participating in MIPS, MSSP

Commenting on proposed rule-making to establish disincentives for “information blocking,” the Medical Group Management Association (MGMA) suggested that federal regulators use corrective action plans and education to remedy information-blocking allegations instead of significant financial penalties.

The MGMA has a membership of more than 60,000 medical practice administrators, executives, and leaders, and represents more than 15,000 group medical practices ranging from small private medical practices to large national health systems.

Information blocking is when a provider knowingly and unreasonably interferes with the access, exchange, or use of electronic health information except as required by law or covered by a regulatory exception.

The Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services’ (CMS) have proposed to establish disincentives for providers who commit information blocking under the 21st Century Cures Act.

In their letter to ONC and CMS, MGMA argues that a corrective action process that allows for providers to rectify offending conduct would most efficiently promote interoperability without dissuading providers from participating in Medicare due to severe financial disincentives. “Properly allowing providers to correct offending conduct by using education and guidance would best facilitate information sharing,” MGMA said. 

The organization suggested that regulators institute an equitable and accessible appeals process for all providers.

MGMA also said it would be a mistake to institute punitive disincentives for providers participating in the Merit-based Incentive Payment System (MIPS) by zeroing out the promoting interoperability (PI) category. “The substantial administrative burden and difficulties medical groups face under the MIPS program will be exacerbated should the agencies move forward with this penalty,” the letter said. A MIPS-eligible clinician would automatically receive at minimum a neutral adjustment due to this policy if they have a perfect score in every other performance category; should the performance threshold increase in future years, this would result in an automatic negative adjustment.

Similarly, MGMA does not support moving forward with removing accountable care organizations (ACOs) and providers participating in ACOs from the Medicare Shared Savings Program (MSSP). “In addition to causing significant administrative and financial barriers, this proposal goes against the agencies’ intention to promote value-based care and undermines providers ability to succeed in MSSP,” MGMA said. “There are myriad negative effects that would result from exclusion such as harming the ability of ACOs to leverage their infrastructure to reduce costs and improve care, damaging vital data collection, increased administrative and financial burdens, and more.”

MGMA said it would like to see increased transparency throughout the process and coordination with other federal agencies to ensure there is a comprehensive strategy that would best promote information sharing by providing guidance and technical assistance to providers. The organization recommends that the Department of Health and Human Services maintain central oversight of all aspects of information blocking and coordinate actions between the different agencies. “More clarity is needed about how the program operates, the applicability of exceptions, and how it intersects with state laws,” the letter stated.

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