The No Surprises Act and 21st Century Cures Act

On January 1, 2022 several provisions of the No Surprises Act were implemented. These provisions included patient protections against balance billing and price transparency policies including good faith estimates for uninsured and self-pay patients. 

In reality this is a complex law with an intention of empowering patients through medical price transparency and ultimately attempting to prevent patients from being charged exorbitant prices meant for health insurance negotiations. We at EvaHealth have championed healthcare information and price transparency for our patients for over twenty years. 

As of April 5, 2021, the program rule on Interoperability, Information Blocking, and ONC Health IT Certification, which implemented the 21st Century Cures Act, went into effect. The “Cures Act” requires healthcare providers give patients access to all of the health information in their electronic medical records “without delay” and without charge.

In addition, starting on October 6, 2022, the definition of electronic health information (EHI) in the 21st Century Cures Act will expand beyond the United States Core Data for Interoperability (USCDI) and include electronic Protected Health Information (ePHI), as defined by the Health Insurance Portability and Accountability Act (HIPAA). 

In the HIPAA Privacy Rule, personal health information (PHI) is considered ANY identifiable health information used, maintained, stored, or transmitted by a covered entity.

In a nut shell the 21st Century Cures Act not only requires providers to provide patients access to their health information, health information now has a much broader scope and covers all personal health information. That is a lot more patient data. And as of April 2021 blocking patients from their own health record is against the law and may result in fines for hospitals and doctors. 

Both the 21st Century Cures Act and the No Surprises Act make sense. To provide complete patient centric care we must not only include the patient, but empower the patient in their health care journey and an open notes system is the solution. 

Our founder and provider Dr.J believed in creating this transparency with his patients when starting his practice, many years ago. Why? Because it is the right thing to do. He believed this transparency supported the patient provider relationship by building trust as well as a foundation for successful collaborative healthcare. The problem at the time, there were no electronic health record systems that provided this transparency AND it wasn’t federally mandated. His solution was to invest years of time, research and investment in building a system centralized around the patient provider relationship that operates in a completely open note format. A fully open note format gives the patient full access to their health information as well as fully transparent access to pricing behind medical services. As a provider he can access the price for every service, procedure, lab, supply and product for a patient easily – from the patient chart. Other systems can’t do this, because they were not built for transparency or patient empowerment. Eva is different and often our new providers can’t imagine that a system like Eva exists. Excellent patient care revolves around trust, transparency and collaboration which can be accomplished with a well-designed and provider-patient relationship centric system like Eva. 

 

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