Information Blocking | Legal Health Information Exchange

HTI-5 and Information Blocking: Your Bots Are Covered, and Your Excuses Are Getting Smaller

HTI-5 and Information Blocking: Your Bots Are Covered, and Your Excuses Are Getting Smaller

by Helen Oscislawski | Jan 2, 2026 | Health IT, HIE & HIN, Information Blocking, Nationals Networks, TEFCA

HTI-5 is calling out two things the market already knows: EHI is increasingly accessed through automation and AI, and “infeasible” has been doing suspiciously heavy lifting in some corners of the ecosystem. If you are an HIE/HIN, a developer of certified health IT, or a provider, these proposed information blocking changes tighten the exception playbook, put contract gating on notice, and make it harder to hide a “no” behind nicer paperwork.

ONC Quietly Dropped Four (4) New Information Blocking FAQs

ONC Quietly Dropped Four (4) New Information Blocking FAQs

by Helen Oscislawski | Dec 22, 2025 | Health IT, Information Blocking, Nationals Networks, TEFCA & QHINs

ONC just dropped four new Information Blocking FAQs on December 19, 2025, and they go straight to the real pressure points: revenue-sharing dressed up as fees, “alternative manner” gamesmanship, and whether automation counts as access. These clarifications matter most where policy meets operations. If you build, sell, operate, or rely on interoperability, this is the set to read.

Are You Blocking? The Coming Crackdown on Information Blocking: What It Means for HIE/HINs, Developers of Certified HIT, & Health Care Providers

Are You Blocking? The Coming Crackdown on Information Blocking: What It Means for HIE/HINs, Developers of Certified HIT, & Health Care Providers

by Helen Oscislawski | Sep 10, 2025 | Government Enforcement, Information Blocking

HHS has declared that the “warning period” for information blocking is over, putting HIEs, HINs, developers, and providers squarely in the path of active enforcement. With OIG empowered to levy million-dollar penalties, ONC able to strip certifications, and CMS now finalizing monetary disincentives for certain providers, the consequences are real and far-reaching. At the same time, long-standing practices, such as conservative privacy policies or restrictive BAAs, may suddenly collide with federal interoperability mandates. This article examines the new enforcement posture, the risks and dilemmas it creates, and what health information networks and their provider members must do to prepare.

Does the TEFCA Exception Hinder Participation?

Does the TEFCA Exception Hinder Participation?

by Helen Oscislawski | Jun 9, 2025 | HIE & HIN, HIPAA, Information Blocking, Nationals Networks, TEFCA, TEFCA & QHINs

HHS has opened the door to one of the biggest questions in health information law: should the TEFCA exception to the information blocking rules stay or go? The May 16, 2025 RFI asks whether this carve-out encourages participation in TEFCA or instead creates confusion and double standards for networks like Carequality, which already impose requirements stricter than HIPAA. With comments due June 16, stakeholders have just days to weigh in on a decision that could reshape the balance between nationwide interoperability and local control.

Do Recent Changes to the Carequality Framework Policies Implicate Information Blocking For Some?

Do Recent Changes to the Carequality Framework Policies Implicate Information Blocking For Some?

by Helen Oscislawski | May 14, 2025 | HIE & HIN, HIPAA, Information Blocking, Nationals Networks, TEFCA & QHINs

Carequality’s new Version 3 Framework Policies add stricter requirements than HIPAA and could expose participants to Information Blocking risks. At the same time, TEFCA alignment creates a paradox: practices permitted under the new TEFCA Exception may still be questioned outside of TEFCA. This article unpacks the double standard—and what it means for HINs, HIEs, and nationwide interoperability.

Health Data, Technology, and Interoperability Rules, HTI-1, 2, & 3

Health Data, Technology, and Interoperability Rules, HTI-1, 2, & 3

by Morgan McDonald | Dec 16, 2024 | Health IT, HIE & HIN, Information Blocking, Legislation & Rulemaking

The landscape of health IT regulation just took another significant leap forward. In the final days of 2024, federal regulators dropped two game-changing rules—HIT-2 and HTI-3—adding to the foundation set by HTI-1. Together, these regulations are reshaping how healthcare organizations approach interoperability, data sharing, and compliance in an era of rapidly evolving technology. But what do these latest rules really mean for healthcare providers, developers, and patients? Let’s break down the impact and key takeaways you need to know.

Lessons Learned from Real Time vs. PointClickCare: Mind your Information Blocking Ps and Qs

Lessons Learned from Real Time vs. PointClickCare: Mind your Information Blocking Ps and Qs

by Krystyna Monticello | Aug 16, 2024 | Government Enforcement, Health IT, HIE & HIN, Information Blocking, Other

A federal district judge has granted preliminary injunctive relief to Real Time Medical Systems, Inc. (“Real Time”) barring the defendant, PointClickCare (“PCC”), from deploying unsolvable CAPTCHAs that interfered with Real Time’s ability to access the data of its skilled nursing facility customers that utilized PCC. As Judge Xinis wrote in the opinion, “No evidence supports that PCC had any legitimate good faith use for wholly inscrutable CAPTCHAs which, by definition, blocked Real Time from getting the very records it needs to exist….But even more damning is the timing of such deployments, which support that PCC used those CAPTCHAs as a device to hamstring or eliminate Real Time as a competitor.” Keep reading for additional details regarding Real Time’s complaints against PointClickCare.

Update: On August 19, 2024, PointClickCare filed a Motion to Expedite Appeal with the United States Court of Appeals for the Fourth Circuit.

The HTI-1 Final Rule and the TEFCA Information Blocking Exception: What It Means for HIEs and HINs

The HTI-1 Final Rule and the TEFCA Information Blocking Exception: What It Means for HIEs and HINs

by Helen Oscislawski | Mar 11, 2024 | HIE & HIN, Information Blocking, TEFCA, TEFCA & QHINs

Effective today, the HTI-1 Final Rule introduces a new TEFCA Manner Exception—potentially a safe harbor for HIEs and HINs under the Information Blocking Rule. But those outside TEFCA may find themselves navigating far narrower exceptions with much higher compliance risk.

Hefty Monetary Disincentives Proposed for Health Care Providers Engaged in Information Blocking – But Not Every Provider Is on the Hook.

Hefty Monetary Disincentives Proposed for Health Care Providers Engaged in Information Blocking – But Not Every Provider Is on the Hook.

by Helen Oscislawski | Oct 31, 2023 | Government Enforcement, Information Blocking

The Proposed Rule for enforcement is out, and the potential financial “hit” that health care providers may face if the OIG finds them to have violated the Information Blocking Rule (IBR) could be substantial, but don’t get spooked. The reach of the proposed enforcement has limitations. Read more to find out why.

Minnesota Supreme Court Finds State Law Permits Health Information to be Shared Because HIPAA Authorizes It

Minnesota Supreme Court Finds State Law Permits Health Information to be Shared Because HIPAA Authorizes It

by Helen Oscislawski | Oct 11, 2023 | HIPAA, HIPAA Privacy, Information Blocking, Lawsuits, Privacy & Consent

The Minnesota Supreme Court held that HIPAA “authorizes” disclosures for purposes of state law and consent was not required for a hospital to disclose PHI to its institutionally related foundation for fundraising purposes. Other states might take a similar stance. The Information Blocking Rule (IBR) prohibits health care providers from interfering with the access and exchange of EHI in an unreasonable manner. State with laws containing similar “as authorized by federal law” exceptions to consent must be carefully considered when claiming the IBR’s Privacy Exception to “block” EHI.

Penalties for Violation of the Information Blocking Rule Start Today!

Penalties for Violation of the Information Blocking Rule Start Today!

by Helen Oscislawski | Sep 1, 2023 | Government Enforcement, Information Blocking

OIG’s authority to begin enforcement of the Information Blocking Rule begins September 1, 2023. Certain Actors subject to the Information Blocking Rule may be subject up to a $1 million penalty per violation! Actors need to be proactive in ensuring their compliance with the Information Blocking Rule and not wait for the OIG to discover them.

ONC Says “Vetting” Mobile Apps is Information Blocking

ONC Says “Vetting” Mobile Apps is Information Blocking

by Helen Oscislawski | May 2, 2023 | HIPAA Security, Information Blocking

ONC says actors that require third-party apps to be “vetted” by them for security reasons before allowing patients to use such apps to receive EHI via API technology certified to the Standardized API certification criterion is likely to be information blocking. However, my concern with relying solely on the security criteria required for API certification is that it is too low of a bar to adequately protect patients and other individuals from developers of apps that fail to keep promises to keep individuals’ information confidential.

ONC Vindicated. Patients Want Immediate Access to Test Results

ONC Vindicated. Patients Want Immediate Access to Test Results

by Helen Oscislawski | Mar 24, 2023 | HIPAA, Information Blocking, Tools & Resources

JAMA published a study earlier this week finding more than 95% wanted immediate access to test results. However, when speaking to ONC, the study’s lead researcher specifically noted that although 95.3% of patients who received abnormal test results responded that they still would like to continue to receive immediately released results, this was associated with nearly twice the likelihood of worry compared to respondents who received normal results.

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