Collapse to view only § 300jj-52. Information blocking
- § 300jj-51. Health information technology enrollment standards and protocols
- § 300jj-52. Information blocking
§ 300jj–51. Health information technology enrollment standards and protocols
(a) In general
(1) Standards and protocols
(2) Methods
(b) ContentThe standards and protocols for electronic enrollment in the Federal and State programs described in subsection (a) shall allow for the following:
(1) Electronic matching against existing Federal and State data, including vital records, employment history, enrollment systems, tax records, and other data determined appropriate by the Secretary to serve as evidence of eligibility and in lieu of paper-based documentation.
(2) Simplification and submission of electronic documentation, digitization of documents, and systems verification of eligibility.
(3) Reuse of stored eligibility information (including documentation) to assist with retention of eligible individuals.
(4) Capability for individuals to apply, recertify and manage their eligibility information online, including at home, at points of service, and other community-based locations.
(5) Ability to expand the enrollment system to integrate new programs, rules, and functionalities, to operate at increased volume, and to apply streamlined verification and eligibility processes to other Federal and State programs, as appropriate.
(6) Notification of eligibility, recertification, and other needed communication regarding eligibility, which may include communication via email and cellular phones.
(7) Other functionalities necessary to provide eligibles with streamlined enrollment process.
(c) Approval and notificationWith respect to any standard or protocol developed under subsection (a) that has been approved by the HIT Advisory Committee, the Secretary—
(1) shall notify States of such standards or protocols; and
(2) may require, as a condition of receiving Federal funds for the health information technology investments, that States or other entities incorporate such standards and protocols into such investments.
(d) Grants for implementation of appropriate enrollment HIT
(1) In general
(2) Eligible entitiesTo be eligible for a grant under this subsection, an entity shall—
(A) be a State, political subdivision of a State, or a local governmental entity; and
(B) submit to the Secretary an application at such time, in such manner, and containing—
(i) a plan to adopt and implement appropriate enrollment technology that includes—(I) proposed reduction in maintenance costs of technology systems;(II) elimination or updating of legacy systems; and(III) demonstrated collaboration with other entities that may receive a grant under this section that are located in the same State, political subdivision, or locality;
(ii) an assurance that the entity will share such appropriate enrollment technology in accordance with paragraph (4); and
(iii) such other information as the Secretary may require.
(3) Sharing
(A) In general
(B) Qualified entities
(July 1, 1944, ch. 373, title XXX, § 3021, as added Pub. L. 111–148, title I, § 1561, Mar. 23, 2010, 124 Stat. 262; amended Pub. L. 114–255, div. A, title IV, § 4003(e)(2)(A)(ii), Dec. 13, 2016, 130 Stat. 1174.)
§ 300jj–52. Information blocking
(a) Definition
(1) In generalIn this section, the term “information blocking” means a practice that—
(A) except as required by law or specified by the Secretary pursuant to rulemaking under paragraph (3), is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information; and
(B)
(i) if conducted by a health information technology developer, exchange, or network, such developer, exchange, or network knows, or should know, that such practice is likely to interfere with, prevent, or materially discourage the access, exchange, or use of electronic health information; or
(ii) if conducted by a health care provider, such provider knows that such practice is unreasonable and is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information.
(2) Practices describedThe information blocking practices described in paragraph (1) may include—
(A) practices that restrict authorized access, exchange, or use under applicable State or Federal law of such information for treatment and other permitted purposes under such applicable law, including transitions between certified health information technologies;
(B) implementing health information technology in nonstandard ways that are likely to substantially increase the complexity or burden of accessing, exchanging, or using electronic health information; and
(C) implementing health information technology in ways that are likely to—
(i) restrict the access, exchange, or use of electronic health information with respect to exporting complete information sets or in transitioning between health information technology systems; or
(ii) lead to fraud, waste, or abuse, or impede innovations and advancements in health information access, exchange, and use, including care delivery enabled by health information technology.
(3) Rulemaking
(4) No enforcement before exception identified
(5) Consultation
(6) Application
(7) Clarification
(b) Inspector General authority
(1) In generalThe inspector general of the Department of Health and Human Services (referred to in this section as the “Inspector General”) may investigate any claim that—
(A) a health information technology developer of certified health information technology or other entity offering certified health information technology—
(i) submitted a false attestation under section 300jj–11(c)(5)(D)(vii) of this title; or
(ii) engaged in information blocking;
(B) a health care provider engaged in information blocking; or
(C) a health information exchange or network engaged in information blocking.
(2) Penalties
(A) Developers, networks, and exchanges
(B) Providers
(C) Procedure
(D) Recovered penalty fundsThe amounts recovered under this paragraph shall be allocated as follows:
(i) Annual operating expenses
(ii) Application to other programs
(E) Authorization of appropriations
(3) Resolution of claims
(A) In general
(B) Limitation on liability
(4) Application of authorities under Inspector General Act of 1978
(c) Identifying barriers to exchange of certified health information technology
(1) Trusted exchange defined
(2) Guidance
(3) Referral
(d) Additional provisions
(1) Information sharing provisions
(2) Protection from disclosure of informationAny information that is received by the National Coordinator in connection with a claim or suggestion of possible information blocking and that could reasonably be expected to facilitate identification of the source of the information—
(A) shall not be disclosed by the National Coordinator except as may be necessary to carry out the purpose of this section;
(B) shall be exempt from mandatory disclosure under section 552 of title 5, as provided by subsection (b)(3) of such section; and
(C) may be used by the Inspector General or Federal Trade Commission for reporting purposes to the extent that such information could not reasonably be expected to facilitate identification of the source of such information.
(3) Standardized process
(A) In generalThe National Coordinator shall implement a standardized process for the public to submit reports on claims of—
(i) health information technology products or developers of such products (or other entities offering such products to health care providers) not being interoperable or resulting in information blocking;
(ii) actions described in subsection (b)(1) that result in information blocking as described in subsection (a); and
(iii) any other act described in subsection (a).
(B) Collection of information
(4) Nonduplication of penalty structures
(July 1, 1944, ch. 373, title XXX, § 3022, as added Pub. L. 114–255, div. A, title IV, § 4004, Dec. 13, 2016, 130 Stat. 1176; amended Pub. L. 116–321, § 2(a), Jan. 5, 2021, 134 Stat. 5073.)