#26 Question [10-12-026-1] Will ONC immediately enforce the new provisions in the Principles of Proper Conduct for ONC-ACBs (45 C.F.R. § 170.523) that require ONC-ACBs to report test results hyperlinks to ONC as well as ensure that EHR technology developers follow “price transparency” requirements?

No.

Reporting of Test Results Hyperlinks to ONC

In the September 4, 2012 standards and certification criteria final rule (77 FR 54163), section 170.523(f) was revised to require an ONC-ACB to provide ONC a hyperlink that enables the public to access the test results used by the ONC-ACB to certify each Complete EHR and EHR Module.

We will only enforce this provision against ONC-ACBs for certifications that are issued:

1. After ONC specifies that the CHPL is capable of posting test results hyperlinks; and
2. For a Complete EHR or EHR Module certified to the 2014 Edition EHR certification criteria.

We anticipate that the posting of test results hyperlinks on the CPHL will be available sometime after testing and certification to the 2014 Edition EHR certification criteria begins. We believe enforcing this provision only for certifications that are issued based on the 2014 Edition EHR certification criteria may reduce potential confusion on the part of health care providers and other consumers of EHR technology. If we were to enforce this provision for certifications issued based on the 2011 Edition EHR certification criteria, the test results used to certify EHR technology under the ONC HIT Certification Program would be publicly available, whereas the test results used under the Temporary Certification Program would not. This could lead to potential confusion for purchasers as to why some 2011 Edition EHR technology has test results available for review but most do not.

Ensuring that EHR Technology Developers Follow “Price Transparency” Requirements

In the September 4, 2012 standards and certification criteria final rule (77 FR 54163), section 170.523(k)(1) was revised to require an ONC-ACB to ensure that a Complete EHR or EHR Module developer discloses any additional types of costs that an EP, EH, or CAH would pay to implement the capabilities a certified Complete EHR or certified EHR Module includes in order to attempt to meet MU objectives and measures. As noted in the final rule, these types of costs are in addition to those costs that an EP, EH, or CAH would pay to purchase (or upgrade to) the EHR technology capabilities for which certification is required. These may be one-time or recurring costs, or both. ONC-ACBs will only be required to ensure that EHR technology developers disclose the types of additional costs – not the actual dollar amounts of such costs.

We will only enforce this provision for certifications issued by ONC-ACBs for EHR technology certified to the 2014 Edition EHR certification criteria. As with the reporting of test results hyperlinks, if we were to enforce this provision with regard to certifications issued based on the 2011 Edition EHR certification criteria, EHR technology certified under the Temporary Certification Program would not be affected. For that reason, we believe this policy may help to reduce potential confusion by consumers of EHR technology.