iiinova — where your digital self keeps evolving

hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 11/08/2026

I'm heading to my 1st ever NACDS TSE, specifically heading up our Pharmacy Network products. If you're heading there, stop by the Optum booth to say hi and learn how our pharmacy solutions can help strengthen patient relationships, simplify claims processing and support reimbursement opportunities.

lnkd.in

This link will take you to a page that’s not on LinkedIn

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 14/05/2026

Fun fact, our BAAs specifically prohibit us from individual access. So yeah pretty much.🤷‍♀️

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 14/05/2026

Honestly, we vendors are in a tough spot here. All of our BAAs require us to abide by law enforcement requests/subpoenas, with only a few states having anything in place to block it. And most of the subpoenas ban us from informing the target that the data is being shared. It's a no win situation.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 08/04/2026

That is fair. Have you looked at Maryland's HIE certification stuff? They take a pretty broad definition of it as well and may have some insights here.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 08/04/2026

So it's not setup so anyone can ask for any data as long as they have a right to under HIPAA. It is setup so only those two parties, the submitter and the intended recipient have access to the data. That's also why clearinghouses can't really support the payer API stuff natively.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 08/04/2026

So if another provider wants that data or if the patient moves to another payer and wants that data, we are not allowed to share it. Same thing is true if the claim is under a group TIN but an individual provider in the group wants the data, you can't share it.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 08/04/2026

Here's the distinction, in a clearinghouse bilateral agreement the data in the transaction belong only to the 2 parties provider and payer, and we are not allowed to share that data with anyone else.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 08/04/2026

If bilateral gets pulled in that would be bad. Clearinghouses literally can't support the HIN requirements under info blocking because of the structure of agreements. It would be a mess. Plus if congress wanted clearinghouses in they would have put them into the law, since we are CEs under HIPAA.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 08/04/2026

Bilateral exchanges are explicitly carved out of the definition of HIN in the final rule. So yeah immunization registries aren't HINs just like clearinghouses aren't. 🤷‍♀️

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 06/02/2026

Yeah we have that, they are called clearinghouses. Optum, Availity, Cognizant, Waystar, etc. Multiple to choose from and bonus all of us have trading partner agreements with each other, so you can pick your best option and still get a single connection point.....

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 30/07/2025

Any other health IT peeps just sitting here today rolling their eyes feeling like they're reliving the same decades over and over again?

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 08/05/2025

Have you done any research on NAD+? I've been very curious about whether it works or not based on all the celebs using it.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 17/04/2025

They were moved under new offices, you have to go to that office page and then you can see the breakdown. They're not eliminated but severely cut.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 17/04/2025

For the folks who thought health IT was bipartisan. ASTP/ONC budget getting cut to $9M down from about $62M. The money hasn't been bipartisan for a while. There are also massive cuts to CDC and NIH. insidemedicine.substack.com/p/scoop-leak...

insidemedicine.substack.com

Scoop: Leaked PDF outlines major HHS restructuring proposal (authenticity now confirmed). "The safety nets are being blown up right and left."

Floated cuts include some programs mandated by Congress.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 01/04/2025

The speed at which it has occurred has been mind blowing. And the courts are barely holding the line. My own congressman received a donation from Musk in return for putting judges up for impeachment. Musk is literally buying votes in Wisconsin. Things are not ok. We must speak up and stand up.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 01/04/2025

B/c we definitely are. This isn't just people being RIFed albeit that is horrible b/c it will damage our country and most vulnerable people so much. But the erosion of congressional authority with absolutely no movement by Republicans to hold their constitutionally given powers has been staggering.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 01/04/2025

If you've not been watching @booker.senate.gov today as he holds the senate floor, you should. I'm a former R, a former Trump appointee, and I still hold actual conservative policy positions (not MAGA positions which are absolutely not that). He is laying out the constitutional crisis we are in.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 14/03/2025

Yeah I try hard not to be a chicken little when I raise issues. But I also have some of the inside info from serving before. Doesn't matter it's just bad. I am a little concerned we will see a Musk takeover with his own tech like we're seeing at the FAA. 🤷‍♀️

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 28/02/2025

Well as a health IT policy wonk this is disappointing. So basically HHS will just be able to publish final rules whenever they want and throw it under the exception clause. I'm not surprised because I expected it, but disappointed. public-inspection.federalregister.gov/2025-03300.pdf

public-inspection.federalregister.gov

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 24/02/2025

For what it's worth, it was likely within the 60 day window of identifying that your data was in the breach. It took a long time for the cybersecurity analysts to sort through all of the data and determine what was breached. This is where ransomware is different than just a standard breach.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 20/02/2025

Riddle me this. If there was a deep state that DOGE was rooting out, wouldn't they have started by firing the federal employees who had been there the longest and most likely to be part of such a conspiracy rather then the brand new folks? The math isn't mathing.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 17/02/2025

They have just opened up the DOGE handles on X for DMs where they're requesting the general public to report FWA. So I think some creative folks should get to flooding those handles with Waste and Abuse created by the Trump admin. You know things like racing your limo around the Daytona track.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 17/02/2025

I am curious what would happen if the admin pushed through a certification rule that disadvantaged or even made it impossible for Epic to play. I imagine they would sue over it. Then again my crystal ball is saying ASTP/ONC may not exist much longer, which I hate to say and don't support.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 17/02/2025

I don't know, seems like nothing is too small to notice. 🤷‍♀️

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 17/02/2025

Just noodling this morning. We watched the last few weeks as USAID was basically eliminated, then Dept of Ed, so what makes us think they won't effectively eliminate ASTP/ONC?

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 16/02/2025

I'm a health IT policy wonk and my specialty is interoperability.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 16/02/2025

So that lawsuit on data access that DOGE thinks it won, seems to be because the judge has declared that they are an agency, which means they would have to follow APA, FOIA, and other laws. So should we start making the FOIA requests now? And who do we think will be the first to sue over APA?

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 14/02/2025

The comms pause wasn't the basis. It's all the other stuff.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 14/02/2025

Roses are red Policy wonks are blue Seems like nothing will be done in HIT this year Do you think that's true? #healthpolicyvalentines

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 06/02/2025

ahrq.gov, ihs.gov and a few others are down but CMS, FDA, and CDC are up. Unclear what that means, did a Jr developer accidentally unplug something?

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 06/02/2025

You are not. As someone who studied poli sci and worked in Washington, yeah we're watching a slow coup. I'm at a loss as to what to do and just hope our judicial system holds up b/c congress certainly isn't.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 31/01/2025

I actually agree with this & would encourage the fine career folks at ASTP/ONC who I have worked w/ as a contractor & as the Deputy to stay & keep working hard. The work you do is incredibly important for patients. But if you do leave, ping me & I'll be happy to recommend you for any job.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 22/01/2025

Very normal when the administration changes. They pull back anything that wasn't released yet as their appointees are taking their place at OMB.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 13/01/2025

I'm really curious about the Library of Congress communication retention requirements and the FOIAbleness of Signal App convos. How has no one filed a lawsuit yet?

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 09/01/2025

Has anyone considered that with Musk's influence within the Admin agencies may be barred from creating Bluesky accounts and be stuck on X? Just a random thought for the day.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 16/12/2024

You have got to be kidding me. Sigh I do not have time to review a final rule that's likely going to get cancelled by the new admin.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 11/12/2024

Some of us feel like we've been shouting scalability of FHIR into a vacuum for years now with most pretending that there isn't an issue and point-to-point is awesome.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 11/12/2024

If they needed TEFCA out this was their best bet b/c it's also no longer economically significant, so this is unlikely to catch notice. The rest of HTI-2, very different story, and will catch notice.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 11/12/2024

So Spring 2024 was the Unified Agenda it was included on. This is just rigamarole of regulatory nuance stuff. That page gives you the description, but the first link indicates it went to OMB 11/22/24.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 11/12/2024

Nope not proposed, states that it's final.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 11/12/2024

This is the link with the full description: www.reginfo.gov/public/do/eA...

reginfo.gov

View Rule

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 11/12/2024

Full description: standards adoption; public HIT cert; expanded uses of certified application programming interfaces (APIs), such as for electronic prior authorization, patient engagement, care management, and care coordination; and information sharing under the information blocking regulations.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 11/12/2024

There is a second final rule. It showed up on the OMB dashboard this morning: www.reginfo.gov/public/do/eo...

reginfo.gov

Pending EO 12866 Regulatory Review

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 11/12/2024

Since I can't remember a proposed rule earlier this year with that name, best guess is that these are the other provisions of HTI-2 that were pulled into their own rule, especially when you read the description which mentions public health, ePA, patient access, APIs, etc.

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hitpolicywonk.bsky.social @hitpolicywonk.bsky.social · 11/12/2024

For the regulatory nerds like myself: ASTP/ONC dropped HTI-2 this morning, a significantly pared down version. However, there is suddenly another final rule at OMB for review called Health Data, Technology, and Interoperability: Protecting Care Access. lnkd.in/ePhNpCnQ

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