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Case: You work for a small managed care organization (MCO) "Splendid Healthcare" that owns a hospital and two provider clinics in. Your MCO just received notice that it will be subject to an HHS OIG evaluation of your electronic health information (EHI) practices because there was a complaint that your organization was engaged in information blocking because you did not release information to the state Medicaid office when they requested it. Honestly, your technology is out of date, and you can't transfer encrypted EHI to meet the state's request.
1) Name and describe and give the code section that gives Medicaid have the right to access your EHI. Name and describe and give the code section that gives the HHS OIG have the right to access your medical records to evaluate information blocking. (Give the legal source of the right)
2) Discuss information blocking requirements and exceptions. How do these apply to this situation? What could you do to bring your EHI up to date so that you don't face an information blocking complaint in the future?
3) What management actions would you take to work with state Medicaid officials to ensure that your organization complies with Medicaid waiver requirements?
4) What management actions would you take to work effectively with HHS OIG to avoid information blocking problems in the future?
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