The Stark Exception has aided in interoperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More of the physician community by allowing health care entities to subsidize physician purchases of electronic health records (EHRElectronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The ... More) items and services, while requiring that subsidized software be interoperable.

The Stark Exception was set to expire at the end of 2013, but on December 23 the government posted new final rules that extend the sunset date to December 31, 2021. This amendment allows health care entities to continue subsidizing physician purchases of EHRs.

Highlights of the rule extension include:

  • Redefined interoperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More
  • Clarification on limiting or restricting interoperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More of subsidized items

    • The donor cannot take action to limit the use, communication, or interoperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More of the EHR by preventing other facilities from interfacing with it
    • Nor can high fees be charged to other facilities for connectivity
    • Complaints to limit interoperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More in any way will be reviewed case-by-case
  • Lab companies are now excluded from donating EHR items and services
  • Removed e-prescribing requirements

InteroperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More is now defined based on compliant EHRElectronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The ... More certification for Meaningful Use. On the date the EHRElectronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The ... More is provided to the physician, it must be a certified EHRElectronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The ... More technology listed on the Certified Health IT Product List managed by the ONCOffice of the National Coordinator for Health Information Technology (ONC) – Located within the Of... More

At a minimum, this currently means that all subsidized EHRs moving forward will have the capability to support Direct Project protocol. And based on the clarifications above, the donating entity cannot require the restriction or limitation of the use of Direct to send secure e-mails in any way.

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