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CMS Clarifies Texting Rules Amid Rumors of mHealth Message Ban

Following a report that CMS had banned all forms of texting for healthcare providers, a letter issued by the agency reaffirms its position that secure mHealth messaging platforms can be used but texting patient orders is still prohibited.

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By Eric Wicklund

- The Centers for Medicare & Medicaid Services has re-affirmed its position on physician texting following news reports that the agency was moving to ban the mHealth messaging platform.

In a Dec. 28 Survey & Certification Letter to state survey agency directors, David R. Wright, director of CMS’ Survey and Certification Group, reiterated that texting patient information among care team members is allowed if it’s done on a secure messaging platform.

Also, Wright noted that certified provider order entry (CPOE) is the preferred platform for provider order entry, and patient orders sent by text are prohibited, regardless of the platform.

“CMS recognizes that the use of texting as a means of communication with other members of the healthcare team has become an essential and valuable means of communication among the team members,” Wright wrote. “In order to be compliant with the CoPs or CfCs, all providers must utilize and maintain systems/platforms that are secure, encrypted, and minimize the risks to patient privacy and confidentiality as per HIPAA regulations and the CoPs or CfCs. It is expected that providers/organizations will implement procedures/processes that routinely assess the security and integrity of the texting systems/platforms that are being utilized, in order to avoid negative outcomes that could compromise the care of patients.”

The CMS letter was in response to a Dec. 18 report from the Health Care Compliance Association that healthcare providers were being told by CMS to halt all texting.

“CMS has sent emails to at least two hospitals saying that ‘texting is not permitted’— and that includes secure text messaging applications,” the association reported, citing what it said was a Nov. 30 e-mail sent by CMS. “Citing concerns about privacy, security and the integrity of medical records, the ‘hospital team’ from the Survey & Certification Group said CMS doesn’t allow texting.”

The healthcare law firm of Hall Render made note of the report in a Dec. 19 blog, in which it urged providers to review all existing mobile device and texting policies. The law firm issued an update on Dec. 28 noting there has been “significant discussion in industry circles” about the supposed ban, then updated that blog one day later with the CMS announcement.

Wright did not address the association’s report in his letter.

In a Dec. 29 LinkedIn post, Nathaniel Lacktman, a healthcare partner with the Foley & Lardner law firm and chair of its telemedicine and virtual care practice, noted CMS hasn’t changed anything, but felt it had to respond to worries raised by providers and telemedicine advocates.

He also noted the CMS position aligns with that of the Joint Commission, which last year lifted its five-year ban on text messaging by physicians, then reinstated it, then came out with new guidance enabling physicians to use secure messaging platforms but barring them from texting patient orders. 

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