Ten hospital and physician organizations have asked Health and Human Services Secretary Xavier Becerra to push back the October 6 information‑blocking deadline by a year, citing ongoing confusion and technical gaps.
Groups request more time and warning notices
The coalition, which includes America’s Essential Hospitals, the American Academy of Family Physicians and the American Medical Association, sent a letter to Becerra on Monday. It argues that despite outreach efforts, many providers and vendors still lack clear guidance on how to meet the rule’s requirements.
In the letter, the groups said they want HHS to issue corrective‑action warning communications before imposing any monetary penalties or launching formal investigations. Such warnings would give stakeholders a chance to address issues without the immediate threat of fines.
According to the filing, the primary obstacle to compliance is the “widespread inability to support access, exchange and use of electronic health information.” The groups note that there is no universally accepted definition of electronic health information (EHI) and that technical infrastructure to securely share it remains underdeveloped.
Complexities around EHI and the eight exceptions
The Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services issued the final rule that bars information‑blocking practices. It mandates API functionality and adoption of Fast Healthcare Interoperability Resources, while also outlining eight specific exceptions that allow certain data not to be shared.
Letter writers point out that stakeholders interpret the scope of EHI, electronic protected health information, and data repository services differently. This lack of consistency makes it hard to determine what data falls under the rule’s umbrella.
“Significant confusion continues to exist on how the eight information‑blocking exceptions are applied when EHI cannot or should not be exchanged,” the groups wrote. They highlight particular concern over how to handle laboratory results and reports in life‑threatening diagnoses, as well as protecting sensitive records such as substance‑use disorder, adolescent mental health, and reproductive information.
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Technical and policy guidance remains sparse, the letter adds, leaving providers unsure how to safeguard these categories while still complying with the rule.
From a practical standpoint, the delay could give hospitals time to upgrade legacy systems and train staff on new APIs, which may reduce the risk of accidental non‑compliance that could otherwise lead to costly penalties. Smaller facilities, in particular, often lack the resources to overhaul their IT environments on a tight schedule.
They need more time.
The groups also said they continue to monitor ONC’s frequently asked questions, but many of the issues they raise remain unanswered. They expressed appreciation for HHS’s efforts to promote health data exchange and advance health equity, yet they stressed that both clinicians and vendors are not yet ready for the looming deadline.
The ONC and CMS rules stem from the 21st Century Cures Act, which aims to improve interoperability across the health‑care system. The CMS Interoperability and Patient Access Rule, issued in 2020, required payers to provide patients with digital access to their protected health information via a standards‑based HL7 FHIR API.
While the current request focuses on a one‑year extension, the letter does not specify a new target date. It does, however, ask HHS to consider a phased approach that would allow providers to demonstrate incremental progress before any penalties are applied.