The American College of Radiology is urging the federal government not to target physicians in enforcing a recently proposed rule.

Health and Human Services first announced on Oct. 30 plans to create new disincentives for providers who knowingly and unreasonably interfere with the exchange of health information. Tuesday was the deadline to submit public comments on the proposal, with ACR weighing in.

The college said it supports the appropriate access, exchange and use of health information by both providers and patients. It recommends that HHS and the Office of the Inspector General focus investigations and disincentives on “clearly intentional, repetitive and objectively anticompetitive ‘bad faith’ behaviors by major actors.”

“Large systems and major institutions typically influence [electronic health information] access, exchange and use within a given region or facility more so than individual physicians, physician practices/departments or smaller provider facilities,” ACR Board of Chancellors Chair Jacqueline A. Bello, MD, wrote Jan. 2. “Accordingly, OIG and CMS should generally prioritize investigations of, and disincentives for, such systems and institutions rather than physicians, practices and smaller providers.”

Bello also urged the administration not to target scenarios where a provider might withhold access to output from a medical device or algorithm, until a physician can review and verify its accuracy. Instead, federal investigations and disincentives should focus on “obviously unreasonable practices, such as egregiously anticompetitive systematic interferences with provider-to-provider exchange.” The feds also should reserve enforcement actions for scenarios where information-blocking caused physical or financial harm, she added.

The college contends that physicians and radiology practices are often unfamiliar with regulations related to this issue and, as such, should be educated rather than punished.

“The ACR recommends that CMS leverage enforcement distraction to ‘hold harmless’ providers—in particular smaller providers and individual physicians—for first-time violations and those with violations despite acting in good faith,” Bello wrote. “Instead, HHS agencies should provide a warning and follow-up information on how to come into compliance with regulatory requirements. Such flexibility/warnings should also be available to providers with first-time violations resulting in multiple claims about the same instance/practice/policy.”

You can read the full letter to HHS here, along with a Jan. 4 news summary from the college. The American Hospital Association also shared its own concerns about the proposal this week.