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Quick Answer

What Is Information Blocking Rule?

The Information Blocking Rule, codified at 45 CFR Part 171 under the 21st Century Cures Act, prohibits health care providers, health IT developers, and health information networks from engaging in practices likely to interfere with access, exchange, or use of electronic health information (EHI), subject to eight regulatory exceptions.

  • Practices should review their portal release policies, request-fulfillment SLAs, and EHI-export capabilities.
  • Any deviation from standard same-time release should be documented against a specific exception.
  • CMS is integrating attestation into MIPS and other quality programs.
Regulation

Information Blocking Rule

Also known as: Info Blocking Rule; ONC Cures Act Final Rule; 45 CFR Part 171

The Information Blocking Rule, codified at 45 CFR Part 171 under the 21st Century Cures Act, prohibits health care providers, health IT developers, and health information networks from engaging in practices likely to interfere with access, exchange, or use of electronic health information (EHI), subject to eight regulatory exceptions.

Definition

Effective April 5, 2021 (and expanded in scope from USCDI v1 to all EHI on October 6, 2022), the Rule prohibits 'information blocking' — a practice by an actor that, except as required by law or covered by an exception, is likely to interfere with the access, exchange, or use of EHI. The eight exceptions split into two categories: Exceptions for Not Fulfilling Requests (Preventing Harm, Privacy, Security, Infeasibility, Health IT Performance) and Exceptions for Fulfilling Requests (Content & Manner, Fees, Licensing). HHS OIG has authority to investigate and impose civil monetary penalties up to $1M per violation on health IT developers and HIEs/HINs. CMS-issued provider disincentives took effect in 2024 (Medicare program penalties).

Example

A practice that requires patients to sign a paper authorization to release records via the patient portal, when the records would otherwise flow automatically, may be information blocking unless an exception applies. A specialist who refuses to send a CCD via Direct Trust because 'we only fax' likely cannot satisfy the Infeasibility exception.

Common Misconceptions

The Rule is not 'all-or-nothing' — interference with even a single request can constitute information blocking if not covered by an exception. A common misconception is that delaying release to permit physician review is permitted; under the Rule, that practice is generally prohibited unless the delay falls under the Preventing Harm exception.

Practical Application

Practices should review their portal release policies, request-fulfillment SLAs, and EHI-export capabilities. Any deviation from standard same-time release should be documented against a specific exception. CMS is integrating attestation into MIPS and other quality programs.

Where This Applies on MedPrecision

№ 99 The Closing Argument

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