Skip to main content

Federal Cures Act

Answered

Comments

11 comments

  • Ruth

    Hi Sara, since we're not legal professionals, we can't advise you on how this federal law will affect your practice. However, we're always looking for ways to support our customers, so if you have an idea for a feature, or function that would be beneficial, please add it to our Ideas and Suggestions Board: http://simplepractice.uservoice.com/.

    We'd love to hear how the Cures Act has impacted other SimplePractice users and their practice. I won't mark this post as "Answered" so other customers can chime in with their experiences! 

    Comment actions Permalink
  • Sara E. Bupp

    Thanks Ruth.  I guess my question for Simple Practice is will you be making our Progress Notes (not psychotherapy notes) available to our clients on the client portal as some other EHR platforms are doing?  I just want to understand if I need to be aware of any change like this and how it will impact my clients going forward. Thanks for any insight you are able to provide. Sara

    Comment actions Permalink
  • Ruth

    Hi Sara, happy to help! We don't have plans to make Progress Notes accessible to clients in the Client Portal. 

    Comment actions Permalink
  • Alinda Gary

    I would like to understand then how this EMR will comply with the new federal law that all physicians have "open notes" that the patients can access on their EMR as of 11/2.

    I am a physician who uses this EMR and that is apparently a requirement as I understand.

    Comment actions Permalink
  • Erica Lubetkin

    I’d like a better understanding of this as well. The new regulations are outlined here: https://www.healthit.gov/curesrule/overview/about-oncs-cures-act-final-rule
    And seem to go into effect November 2.

    Comment actions Permalink
  • Sara E. Bupp

    Alinda & Erica,

    From what I've been able to ascertain, from reading the new laws, there still remains the caviot that we as practitioners for MH & SUD are able to protect client files as sensitive in nature if disclosing them would result negatively in impacting the client.  I believe this is the caviot that Simple Practice is utilizing to allow us to be able to choose what we disclose and what we do not to protect our clients.  They are allowing us to print the notes from each client's chart (or send them securely through the portal), but on a case by case basis rather than a blanket open note process.  A lot of the information contained in the new laws is in direct reference to large, hospital based treatment, rather than smaller private practices.  This is what I've been able to understand from reading, researching and interacting with other practice owners & licensing/legal bodies.  While this is not interpreted through the lens of a physician, this is my general understanding of the new laws with regard to MH/SUD treatment from the point of view as an LPC.  I hope this helps you in some way.  It's so difficult to not have concrete direction on this.  The best explanation I have found on this is from American Psychiatry Assoc.

    https://www.psychiatry.org/psychiatrists/practice/practice-management/health-information-technology/interoperability-and-information-blocking

    Sara

    Comment actions Permalink
  • Ruth

    Hi Everyone, to clarify, SimplePractice isn't subject to The Cures Act and neither are the clinicians who use SimplePractice as an EHR.

    The Cures Act is a condition to maintain ONC Certification, most often held by EHRs for large hospitals, clinics, or organizations that provide lab testing and have to do federal reporting. Since #so isn't ONC Certified, we're not obligated to follow the requirements of The Cures Act. ONC Certification is optional and isn't necessarily beneficial for EHRs like SimplePractice to obtain. Please let me know if you have any additional questions! 

    Comment actions Permalink
  • Samantha Yerks

    I see the point that SP may not be seeking ONC certification, but where do you see providers are exempt from this? I read a bunch of stuff and did not see an exemption for therapists. But if we are obligated- isn’t SP then? And in order to block information you would have to identify reasons why- and you would not want to do that for an entire record, you have to have justification and noted justification somewhere in your record.

    Comment actions Permalink
  • Samantha Yerks

    Here is a page from another EHR
    https://www.opennotes.org/onc-federal-rule-interoperabilty-information-blocking-and-open-notes/

    and from healthIT

    https://www.healthit.gov/sites/default/files/cures/2020-03/InformationBlockingActors.pdf

    I am not sure here- but I think this is pointing to us - Providers- being liable if our EHR is not compliant? 


    Comment actions Permalink
  • Kimela Kluthe, LMFT

    This is a small Sub-Exception part of the Cures Act, but may be relevant and may be why SP isn't worried about it (what is in bold was what I thought may apply to us). This document - like all government documents - is extremely long: 

    "SUB-EXCEPTION 3: DENIAL OF AN INDIVIDUAL'S REQUEST FOR THEIR ELECTRONIC PROTECTED HEALTH INFORMATION IN THE CIRCUMSTANCES PROVIDED IN 45 CFR 164.524(A)(1) AND (2)

    We proposed a limited sub-exception to the information blocking provision that would permit a covered entity or business associate to deny an individual's request for access to their PHI in the circumstances provided under 45 CFR 164.524(a)(1) (2) and (3). We noted that this exception would avoid a potential conflict between the HIPAA Privacy Rule and the information blocking provision. Specifically, the HIPAA Privacy Rule contemplates circumstances under which covered entities, and in some instances business associates, may deny an individual access to PHI and distinguishes those grounds for denial which are reviewable from those which are not. We proposed that this exception applies to both the “unreviewable grounds” and “reviewable grounds” of access. We noted that the “unreviewable grounds” for denial for individuals include situations involving: (1) Certain requests that are made by inmates of correctional institutions; (2) information created or obtained during research that includes treatment, if certain conditions are met; (3) denials permitted by the Privacy Act; and (4) information obtained from non-health care providers pursuant to promises of confidentiality. In addition, we noted that two categories of information are expressly excluded from the HIPAA Privacy Rule individual right of access: (1) Psychotherapy notes, which are the notes recorded by a health care provider who is a mental health professional documenting or analyzing the contents of a conversation during a private counseling session and that are maintained separate from the rest of the patient's medical record; and (2) information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding.[167]

    Comment actions Permalink
  • Ruth

    Hi Everyone, SimplePractice isn't ONC Certified. If you look at the links Samantha provided, they specifically refer to ONC Certified EHRs. ONC Certification is usually obtained by EHRs who service large hospitals, or organizations that incorporate lab testing and federal reporting. EHRs are not required to be ONC Certified, but for those that are certified, it is a requirement of their ongoing certification that they abide by the new Federal Cures Act. Since SimplePractice isn't ONC Certified, neither SimplePractice, nor our customers are required to abide by the Federal Cures Act. You can refer to this Health IT Article for more information. 

    Comment actions Permalink

Please sign in to leave a comment.