The new requirement applies to hospitals (including psychiatric hospitals and critical access hospitals) that participate in Medicare or Medicaid and have an electronic system using HL7 version 2.5.1 or newer. This is typically the patient registration system, which can be a stand-alone administrative system or part of an electronic health record (EHR) system.
Hospitals with these technical capabilities must use reasonable efforts to send real-time alerts — directly or through an intermediary, such as an HIE — to the patient’s PACs and PCPs who need to receive notification of the patient’s status for treatment, care coordination or quality improvement purposes.
Non-compliance may threaten a hospital’s certification and ability to recoup payments from Medicare and Medicaid. Therefore, it’s critical that hospitals understand the updated CoP and have a plan in place to meet the technical and administrative requirements.