FLHIE CMS Hospital eNotification Requirement Overview

Sep 28, 2020 | Case Studies

Concerned about the New CMS Hospital eNotification Requirement? The Florida HIE’s ENS® is your solution.

The Florida Health Information Exchange’s (Florida HIE’s) Encounter Notification Service (ENS) is Florida’s statewide alerting service, providing timely notifications on patients’ health care encounters.
Earlier this year the Centers for Medicare and Medicaid Services (CMS) finalized their Interoperability and Patient Access Final Rule. Starting in May 2021, a new CMS Condition of Participation (CoP) requires Medicare and Medicaid participating hospitals (including psychiatric hospitals and critical access hospitals) to send notifications of hospital admission, discharge, or transfer to the patient’s Primary Care Provider (PCP), post-acute facility, and/or any other providers/entities specified by the patient for purposes of treatment,
care coordination, or quality improvement. A more detailed summary of the rule and the requirements can be found here.

If you are a hospital participating in the Florida HIE’s ENS, you have already fulfilled the vast majority of this requirement.

The Florida HIE has a roadmap in place to ensure total compliance with these rules through participation in ENS. The Florida HIE is connected to health care organizations statewide, with 95% of the acute care hospitals across the state currently sending their real-time ADT data feeds for the purposes of notifying other health care entities of their attributed patient encounters. As the largest network of connected health care organizations across the state, the Florida HIE is positioned to best serve hospitals as the CMS-allowed “intermediary” to facilitate broad connectivity to providers. By using ENS, hospitals and the receiving providers, post-acute organizations, and other entities eliminate the need to create multiple point-to-point connections. Additionally, the HIE can help hospitals to ensure that the providers and organizations they want to receive the alerts are subscribed to ENS.

CMS CoP Requirement
Hospitals must send notifications to providers, as applicable, for the purposes of treatment, care coordination, or quality improvement purposes
Provider types must include PCP, post-acute facilities, and any other provider or entity identified by the patient
Notification events must include a patient’s inpatient, emergency department or observation admission, discharge or transfer (outpatient to inpatient only)
Notification Settings must include emergency, inpatient, and observation status
Minimum notification content must include patient name, treating provider, and sending institution name
Notifications must be sent in real-time as patient is admitted, discharged and/or transferred
Hospital must demonstrate it has made a reasonable effort to ensure that the system sends the notifications to required providers
Hospitals must set up policies and procedures regarding rule compliance
✓ = ENS Covers

Current Statewide ENS Connectivity:

• ENS currently receives encounter data from over 400 Florida health care entities, including hospitals, skilled nursing facilities, home health, and hospice

• Thousands of health care providers from hospitals, physician practices, post-acute care, ACOs, and health plans receive ENS alerts by directly subscribing

If your organization would like more information about how the Florida HIE is helping hospitals and ambulatory practices meet the requirements of the eNotification CoP or you have questions about your organization’s compliance, please contact the Florida HIE Service Desk at FLHIE-ServiceDesk@ainq.com.