The rule was finalized by CMS in March 2020 and was published to the Federal Register on May 1, 2020. The new requirement will go into effect on May 1, 2021. This new provision also adds to the list of CoPs hospitals must meet in order to maintain their CMS certification and continue to receive CMS payments.

Andor Health’s mobile collaboration platform, ThinkAndor®, provides 100% full compliance with the CMS Interoperability rule.

• E-Notifications for patient’s admittance, discharge, or transfer event
• Support for delivery both credentialed and non-credentialed clinicians
• Digital Preference settings for clinicians

• Real-time collaboration via chat, conference call and video
• Complete integration into Microsoft Teams
• AI and natural language processing for note and task creation

• Only providers that pay to participate in HIEs get patient event notifications, but the new regulation states that health systems need to notify ALL providers
• HIEs are unable to gather discharge and transfer data efficiently to send notifications, creating significant risk for non-compliance
• These approaches don’t close the loop with patients

CMS sets the minimum requirements required to provide safe and effective treatment to patients and focuses on improving quality of care. These CoPs address many aspects of hospital operations and set policies and procedures related to patient rights, clinical documentation, staffing, infection control and compliance with legislation, to name a few.

State Survey Agencies and Accreditation Organizations use the CoPs to guide their audits during surveys. These surveys may be unannounced and deficiencies often lead to certification termination.

Additionally, lack of compliance will invoke of time sensitive corrective action procedures. These corrective actions must be addressed by the established deadlines or certification and payments will cease. Given that Medicare patients typically represent approximately 40% of a hospital’s payer-mix and Medicaid patients generally represent 20% of a typical payer-mix, this is a significant threat.

Surveys or compliance audits are unannounced and can either be conducted by the designated State Survey Agency or a CMS-approved Accreditation Organization. Hospitals are assessed for all CoPs as one entity for compliance purposes. Refusal to participate in a survey may lead termination certification.