Health Information Exchange Rules and Exemptions
In response to the Governor’s recent veto, the Oklahoma Health Care Authority (OHCA) swiftly drafted a set of emergency rules with noteworthy modifications to the Health Information Exchange (HIE) system. These new measures, encompassing the mandates of Oklahoma Senate Bill 1369, have taken into account inputs from various stakeholders including healthcare providers, members, and the Governor. A vital aspect of these emergency rules allows any healthcare provider to register for an exemption from reporting data to the Oklahoma Statewide Health Information Network and Exchange (OKSHINE), the state-designated entity (SDE) for HIE, through the Office of the State Coordinator for HIE.
- Inclusive Exemptions for ProvidersThe newly proposed rules grant a substantial degree of flexibility to providers seeking exemptions from participation. Under these regulations, all providers who wish to opt out of the system are given the liberty to do so, thereby accommodating different operational needs across the healthcare spectrum.
- Expanded and Refined DefinitionsTo ensure clarity and ease of understanding, several existing definitions have been revised and additional ones have been introduced. This amendment aims to offer comprehensive insights into the healthcare information exchange’s landscape, thereby streamlining processes for all involved parties.
- Detailed Participation RequirementsThe rules also provide a more detailed picture of mandatory participation. It clarifies who must participate in the health information exchange, shedding light on the circumstances that mandate participation and those that permit providers to opt out.
- Sustained Compliance with State and Federal LawsAs patient privacy continues to be of utmost importance, these rules reiterate the strict adherence to state and federal laws related to patient disclosure and consent. This ensures that patient-specific protected health information will continue to require explicit patient consent before any disclosure, ensuring the privacy rights of all individuals are protected.
- Established Fee Structures and Financial AidThe rules define the financial aspects more clearly. They set out the participation fee and connection fee, offering a transparent overview of the costs associated with joining and maintaining a presence within the HIE. Moreover, the provision of grant funds to cover connection fees has also been highlighted, signifying the authority’s commitment to assist healthcare providers financially, ensuring a smooth transition towards this comprehensive health information exchange system.
Any providers that register an exemption will be exempted without any charge for subscription fees and/or connection fees. Further, the exemption will automatically renew annually, barring a provider’s decision to withdraw their exemption and participate in the HIE system. While non-exempt providers must establish a secure connection with OKSHINE and submit data based on the United States Core Data for Interoperability (USCDI) standard, certain providers including those without electronic health records technology or substance abuse treatment facilities governed by the 42 Code of Federal Regulations (CFR) Part 2 are not bound by this rule. It should also be noted that patient-specific protected health information remains secure, requiring patient consent before disclosure in strict compliance with state or federal laws.
Financial Implications and Support for Providers
This revamp of the HIE system will have widespread impact on healthcare providers and citizens of Oklahoma. While establishing a connection with the statewide HIE will be associated with certain costs, OHCA has ensured the availability of grant funds to assist providers with these connection fees, minimizing the financial strain. In addition to this, providers are obliged to pay a subscription fee to the SDE, whose value is determined by the SDE itself. Notwithstanding this, providers may expect grant funds to cover these subscription costs as well. All changes accompanying this rule have been designed to remain budget-neutral for the OHCA. These alterations are intended to upgrade the statewide HIE, bolstering the security of member information, harmonizing member care, and refining the efficiency of healthcare delivery. OHCA anticipates that the new rules will enhance health outcomes in the state by enabling a more efficient exchange of health information among authorized individuals and healthcare organizations. While the authority does not foresee any adverse economic effects on political subdivisions or small businesses, it recognizes the time-intensive nature of establishing a connection to the HIE.
Upcoming Consultation Meetings and Deadlines
The OHCA has slated a series of meetings for discussing the proposed changes. These changes were initially introduced as a Permanent rule at the September 6, 2022 Tribal Consultation, the September 8, 2022 Medical Advisory Committee, and the March 22, 2023 OHCA Board of Directors meeting. The revised policy, now termed as an Emergency Rule, is scheduled to be presented at the July 5, 2023 Tribal Consultation meeting, July 13, 2023 Special MAC meeting, and July 17, 2023 Special OHCA Board of Directors meeting. It should be noted that the deadline for comments on the proposed policy is July 14, 2023.