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EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
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EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
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Will We See a Delay in the Cures Act Mandates with a New Administration?
Mar 26, 2021
In May of 2020, our IQVIA experts published a white paper titled Cures Act: Getting Ready for the Implementation of TEFCA and Healthcare Interoperability Standards. So much has happened since that time. The global COVID-19 pandemic changed the face of public health as we know it, putting tremendous stresses on patients, families, providers, health systems, and payers alike.
A year has passed since the coronavirus first swept the country, but we’re now faced with changes once again. After a turbulent election season, the country has a new administration. With new leadership in the White House and in Congress, we can expect to see many policies modified, reversed, or eliminated. Due to that fact, we’ve heard questions from clients asking if they can expect a delay in implementation of the Cures Act.
The short answer is: NO.
More specifically, as of this writing, there will be no delay of the information blocking provisions nor of the Patient Access API. CMS exercised enforcement discretion for the Patient Access API and Provider Directory API policies for Medicare Advantage, Medicaid, and CHIP in January 2021, and is now beginning enforcement for both of these.
Vaccines are a light at the end of the proverbial COVID-19 tunnel, but the fact remains that we are still in the grips of this pandemic. Interoperability can be a powerful tool to provide more timely access to treatments to those in need of care. Physical locations of care have been shuttered or have had access altered during the pandemic, forcing patients to seek new locations and new modes of interacting with different health systems in their local communities.
Consider the patient who has difficulty or is unable to speak, or the patient with memory deficits. How can they relate their past medical history to their care providers? How can they be expected to provide a list of every single medication they’ve been prescribed, or every over-the-counter supplement they take? These facts become even more critical considering that pre-existing conditions can determine the severity of COVID-19 infections, the corresponding cost of care, and ultimately the clinical outcomes themselves.
Interoperability allows providers to give better care to their patients by having this information at their fingertips, whether they’ve switched providers or have multiple specialists involved in their care. With a few clicks, physicians and other healthcare workers will have access to that data, avoiding potentially catastrophic lapses in care due to incomplete information.
Additionally, payers will have the ability to offer quicker solutions to both care providers and patients alike. There will be no need for repeat tests when the record clearly shows those tests have already been performed. This means less unnecessary expenditures of time and money for all involved.
Remember that The Cures Act is evolving, and that July 1st does not represent the only significant deadline; on January 1st, 2022, the Payer-to-Payer portion goes into effect, wherein a participating member of an insurance plan who switches coverage can request their previous payer to send data all the way back from 2016 to their new payer. And this doesn’t just apply to one payer; if the member switched coverage more than once within that period, then each of the payers will be required to forward that data.
All this is to say — now is not the time to take your foot off the gas.
If you’re on track with your implementation — keep going. If not, the time to start was yesterday. The good news is, we at IQVIA are here to help. Our experts can provide guidance and expertise to assist you in your compliance efforts as you strive to meet dates not only to avoid costly financial penalties, but to arm yourselves — and all of us — with the tools needed to conquer this pandemic.
White Paper: Catch up on the Cures Act
Are you ready for July 1, 2021? Organizations must get started right away on assessing the efforts needed to get ready for the Cures Act and TEFCA.