Dear NAACCR members,
We are writing to share an update on the newly proposed Assistant Secretary for Technology Policy (ASTP/ONC) update to existing Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) rule and proposed Health Data, Technology, and Interoperability: Deregulatory Actions to Unleash Prosperity (HTI-5) rule that would impact CDA reporting of cancer to central cancer registries. We invite your participation in NAACCR's review and comment process.
NAACCR has developed a draft comment in response to the HTI-5 proposed rule and welcomes member input.
To support community review and discussion, NAACCR will host a webinar on February 9 at 2:00 p.m. ET. During this webinar, we will share our current interpretation of the rules, provide a draft comment, and an opportunity for questions and discussion. We strongly encourage members to attend and participate. Use this link to register for the webinar: ASTP/ONC HTI-5 Proposed Rule NAACCR Webinar
Brief Context: HTI-2 Rule
By way of background, the HTI-2 rule, originally published on August 5, 2024, addressed health information technology, information blocking, and the Trusted Exchange Framework and Common Agreement (TEFCA). ASTP/ONC reviewed the remaining public comments, and several provisions that were not finalized in the publication were recently withdrawn. As part of this update to the rule, the United States Core Data for Interoperability (USCDI) Version 4 was adopted. The proposal became effective on December 29, 2025.
Key Points for discussion: HTI-5 Proposed Rule
ASTP/ONC has now issued the HTI-5 proposed rule, which aligns with current administration priorities outlined in Executive Order 14192 (Unleashing Prosperity through Deregulation) and Executive Order 14267 (Reducing Anti-Competitive Regulatory Barriers).
The proposal seeks to:
- Reduce burden on health IT developers by streamlining the ONC Health IT Certification Program by removing redundant requirements
- Update information blocking regulations to better promote electronic health information access, exchange, and use ensuring patients' access to their data is not blocked
- Advance a new foundation for AI-enabled interoperability solutions through modernized standards and certification
Of relevance to the NAACCR community, the proposed rule removes Certification Companion Guide v1.4, "Transmission to Cancer Registries," effective January 1, 2027. This change is presumed to be associated with Certified Electronic Health Record Technology (CEHRT) requirements for CDA document support for physician reporting.
In addition, the proposal supports the continued transition of cancer registry reporting from CDA to FHIR, referencing the Helios FHIR Accelerator and the Central Cancer Registry Reporting (CCRR) FHIR Implementation Guide (IG).
The public comment period for HTI-5 is open until February 27 at 11:59 p.m. ET.
Following the webinar, members are invited to submit suggestions or feedback on the draft comment by close of business on Friday, February 20.
Thank you for your continued engagement and contributions as we assess the potential impacts of HTI-5 on cancer registry reporting and interoperability.
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Ashley Knealing
Program Manager of Informatics and Registry Development
email:
aknealing@naaccr.orgNAACCR, Inc.
(217) 698-0800 ext. 120
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