In May 2020, the Centers for Medicare & Medicaid Services (CMS) published the CMS Interoperability and Patient Access final rule that adds a new Condition of Participation (CoP) for hospitals. In an effort to support the care continuum, CMS will soon require hospitals to alert primary care providers (PCPs) and post-acute care providers (PACs) when patients are admitted, discharged, or transferred from the emergency department (ED) or inpatient services. CMS refers to these alerts as Patient Event Notifications. The deadline for hospitals to comply with the new requirement is May 2, 2021.

The new alert requirements apply 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 a health information exchange (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 is critical that hospitals understand the new CoP and have a plan in place to meet the technical and administrative requirements. Health Current is here to help.

Through leveraging existing technical infrastructure between hospitals and the HIE, and expanding capabilities to engage and connect with primary care and post-acute providers, Health Current can help your organization meet the new CMS requirement.

To learn more about our capabilities, contact Peter Steinken, Director of Community Engagement, at (602) 464-9641 or peter.steinken@healthcurrent.org.

CMS CoP FLYER – CLICK HERE TO DOWNLOAD

CMS CoP WHITE PAPER – CLICK HERE TO DOWNLOAD