b'CODING Update ComplianceLEGAL NUTRITIONUpdateANJC NewsANJC Leadership ANJC News!Cures Act LEGAL EASE NUTRITION Open Notes Rule By Jeffrey RandolphANJC Legal Counsel There are also exceptions provided for under the rule thatREHAB Update ANJC Scholarshipsestablish a so called Safe Harbor, that, if followed, ensure that a provider is not engaging in improper information blocking. If any of the exceptions are met, the information can be blocked from patient access without liability. The exceptions most applicable to chiropractic physicians are:1) Preventing harm exceptionengaging in practices thatCHIRO Assist or another person LEGAL Q&Aare reasonable and necessary to prevent harm to a patient Executive Directors Update 2) Privacy exceptionfailing to fulfill a request for informa- 3) tion in order to protect an individuals privacy 2020 ANJC AWARDSSecurity exceptionfailing to fulfill a request for informa- On March 9, 2020, the U.S. Department of Health & Humantion in order to protect the security of EHR.4) Work Product/Litigation exceptioninformation compiled Services (DHHS) issued a new rule under the Cures Act that is intended to give patients safe, secure access to theirin reasonable anticipation of, or use in, a civil, criminal, or health data so they may make better healthcare decisions forLegislative Updateadministrative action or proceeding. INSURANCE Update themselves. The rule, referred to commonly as the OpenEach exception is qualified by the language provided certain INSURANCE Update conditions are met. Therefore, each exception is fact-specific Notes Rule, prohibits healthcare providers from information blocking.and no bright line rule is provided for guidance and noTECHNIQUE UpdateThe Open Notes Rule, among other things, provides freeexamples are set forth in the rule.patient access to certain aspects of their clinical chart, andPlease note that this rule applies to all patient records failure of a healthcare provider to provide this access wouldcontained in an electronic medium. Thus, if you keep your be considered improper information blocking. The rule isrecords electronically you must provide access to patients intended to allow patients to securely and easily obtain theirimmediately, free of charge, and cannot charge the $1 per electronic health information from their healthcare providers MedicareQ&AMedicare Updatepage up to a $100 maximum for the entire chart withing thirty Electronic Health Record (EHR) system for free. Failure todays of a written request provided for by New Jersey regula- OUR HEALTHmake the required information available to patients electroni- tions. However, if you maintain only paper records you are not cally will constitute information blocking and be punishablecovered by the rule and can follow the New Jersey regulations under the rule. above for providing copies of patient records. With limited exceptions, the Open Notes Rule grants patientsIn conclusion, the Open Notes Rule applies to all healthcare access to health information in their electronic medical record,providers as well as health information exchanges and without charge by the provider, including the notes theircertified health information technology developers. Under physician generates. The following eight types of patientthe rule, clinical notes not meeting any exception must be information must be made available to patients electronically: shared by health providers starting April 5, 2021. There is 1)Consultation Notes an additional provision under the rule, effective October 6, 2)Discharge Summary Notes 2022, that such information must be made available through 3)History and Physical a patient portal type access or third-party application on the 4)Imaging Reports patients smart phone or other electronic device. 5)Laboratory Reports All providers should review their EHR systems and consult 6)Pathology Reports with their IT professional to ensure that they can provide open 7)Procedure Notes access to their electronic records as detailed above as of April 8)Progress Notes 5, 2021. In addition, though over a year and a half away, it While these categories cover a variety of healthcare providers,would also be prudent to start inquiring as to how to comply and not all may be applicable to chiropractic physicians,with the patient portal/application access requirements that at a minimum a chiropractic physician must make availablewill take effect in October of 2022, as this deadline will come electronic records consisting of: i) initial exams; ii) daily SOAPbefore we know it. There will likely be numerous products notes; iii) follow-up exams; iv) discharge exams/narratives; andand applications on the market to facilitate this access and v) any narrative where the chiropractor references the resultseach should be reviewed on their merits and cost basis by the of imaging or other diagnostic testing.provider and their IT professional.6 I Spring 2021 www.anjc.info'