Would it be considered an interference under the information blocking regulations if a health IT developer of certified health IT limited a customer’s or a user’s choice of QHINs for the purposes of participating in TEFCA?

Yes, it would likely be considered an interference with the access, exchange, or use of EHI if an actor restricts or impedes a customer or user from obtaining or using the QHIN connectivity services of their choice because such services provide for the access, exchange, and use of EHI.

The information blocking law (42 U.S.C. § 300jj-52) may be implicated when an actor engages in exclusionary, discriminatory, or other practices that impede the dissemination or use of interoperable technologies and services, and that interfere with the access, exchange, or use of EHI (85 FR 25813-25814). Examples of practices by a developer of certified health IT that would likely be an interference include practices that restrict or impede a customer’s or a user’s access, exchange, or use of EHI through QHIN connectivity services by: establishing contractual terms that limit or have the effect of reducing the choices of a customer or user to use any QHIN; imposing unreasonable fees for access to certain QHINs; and taking unnecessary time for configuration changes or other technical steps needed to use a QHIN’s connectivity services. Each of these examples would be especially concerning when the QHIN may be a competitor of the actor because it may indicate that different fee structures or terms do not reflect genuine differences in the cost or the effort required to provide access, exchange, or use of EHI (85 FR 25814, 85 FR 25881-25882; 45 CFR 170.302(a)(2)).

ID:IB.FAQ53.1.2025JUL