Federal policy efforts to advance health data exchange and interoperability are continuing to change rapidly. The latest changes are the publication of two final rules by the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC) finalizing parts of the Health Data, Technology, and Interoperability (HTI-2) Proposed Rule. These rules adopt requirements regarding the Trusted Exchange Framework and Common Agreement (TEFCA) (HTI-2 Final Rule), and create a new Information Blocking exception under Protecting Care Access (HTI-3 Final Rule), published on December 16th and 17th, respectively.

The HTI-2 Final Rule focuses on changes to CFR Parts 170 and 171, finalizing updates to the Privacy and Security Framework criterion and certification, information blocking regulations including definitions related to the TEFCA Manner Exception, and several administrative updates. This regulation comes in the wake of recent policy developments released by the Recognized Coordinating Entity in coordination with ASTP/ONC. This rule is effective on January 15, 2025.

HTI-3 Final Rule finalizes proposals related to reproductive health data and information blocking regulations, including modifications to the existing information blocking exceptions (Privacy Exception and Infeasibility Exception) and a new information blocking exception (Protecting Care Access). This rule was effective upon publication.

The release of HTI-2 and HTI-3 Final Rules is intended to advance interoperability and support the access, exchange, and use of electronic health information. We note that there are a number of proposed changes with regards to health IT certification that were not finalized. We expect that ASTP/ONC will continue to work on these changes with the intent of finalizing them in 2025.

For more information, please see our client alert summarizing the most relevant components of HTI-2 and HTI-3 Final Rules.

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Photo of Jennifer Mika Jennifer Mika

Jen Mika is a seasoned litigator and regulatory counselor who advises health systems, managed care plans, and other institutional clients on innovative legal solutions. Drawing on more than a decade of experience in government practice, Jen offers clients deep knowledge of compliance with

Jen Mika is a seasoned litigator and regulatory counselor who advises health systems, managed care plans, and other institutional clients on innovative legal solutions. Drawing on more than a decade of experience in government practice, Jen offers clients deep knowledge of compliance with federal and local health care law and a winning track record litigating complex issues. Her distinguished career in government focused on protecting vulnerable populations and included senior roles at the United States Attorney’s Office for the District of Columbia, District of Columbia Office of the Attorney General, and District of Columbia Department on Disability Services.

Most recently, Jen served as the Pretrial Mental Health Coordinator for the United States Attorney’s Office for the District of Columbia. In this role, she provided specialized guidance on prosecuting cases in which defendants raise mental health issues, such as competency to stand trial and insanity. Jen successfully first chaired eight contested competency trials involving complex issues related to the diagnosis of major mental illnesses and intellectual and developmental disabilities and the implications of these diagnoses on a defendant’s ability to understand criminal proceedings. In addition to her work in the courtroom, Jen was instrumental in improving coordination between District agencies and mental health providers and encouraged the use of diversion programs such as Mental Health Community Court.

Jen is also considered a leading authority on Elder Law in the District of Columbia. In addition to her years of experience litigating fiduciary and probate matters, she was the District of Columbia’s first prosecutor solely focused on investigating and prosecuting financial exploitation of elders and vulnerable adults. She successfully handled the first jury trial involving the charge of Financial Exploitation of an Elderly Person, and obtained convictions in cases involving bank employees, members of the clergy, and home health aides exploiting the elders and vulnerable adults. Jen regularly discusses financial exploitation issues on behalf of the government with the press and at events organized by the DOJ Elder Justice Initiative, D.C. Bar, and various D.C. agencies and non-profit organizations.

Jen has extensive experience finding legislative solutions for her clients. She has testified before the D.C. Council several times to provide valued insight on various successful legislative initiatives for which she was the principal drafter, including the Disability Services Reform Amendment Act of 2018 (Law 22-93), which ended involuntary civil commitment and established supported decision making for people with disabilities.

Photo of Tai Williams Tai Williams

Tai is an associate in Crowell & Moring’s Washington, D.C. office and a member of the firm’s International Dispute Resolution and Health Care groups.

As a member of Crowell’s International Dispute Resolution Group, Tai has experience advising investors in complex cross-border investment arbitrations.

Tai is an associate in Crowell & Moring’s Washington, D.C. office and a member of the firm’s International Dispute Resolution and Health Care groups.

As a member of Crowell’s International Dispute Resolution Group, Tai has experience advising investors in complex cross-border investment arbitrations. She also represents foreign and domestic clients in Foreign Sovereign Immunities Act (FSIA) and Anti-Terrorism Act (ATA) litigation, which includes victims of terrorism around the globe.

As a member of the Health Care Group, Tai counsels and represents managed care organizations, insurers, health care providers, and health care technology companies in various regulatory, transactional, and litigation matters. She works with health care entities seeking to comply with federal and state laws and regulations, including those related to fraud and abuse.

Photo of Eunice Lalanne Eunice Lalanne

Eunice Lalanne supports Crowell Health Solutions, a strategic consulting firm affiliated with Crowell & Moring, to help clients pursue and deliver innovative alternatives to the traditional approaches of providing and paying for health care, including through digital health, health equity, and value-based health…

Eunice Lalanne supports Crowell Health Solutions, a strategic consulting firm affiliated with Crowell & Moring, to help clients pursue and deliver innovative alternatives to the traditional approaches of providing and paying for health care, including through digital health, health equity, and value-based health care. She is a health care policy consultant in the Washington, D.C. office.