Exemption Guidelines

The provider/organization is required to complete the online exemption form or apply to join the HIE unless covered by a broad-based exemption. Once received, exemption requests are subject to review and approval by OHCA. Approval or denial will be sent to the email provided on the exemption application.

General Notes

• Providers qualifying for an exemption are encouraged to participate in the HIE on a voluntary basis.
• Exemption from the state HIE mandate does not constitute an exemption from other federal or state requirements for interoperability, or from the provider meeting the standard of care expected by their profession.
• Broad-based exemptions are for providers who are not expected to apply for exemption or make an application. The provider should be prepared to supply appropriate documentation showing they meet the exemption criteria upon request.
• To utilize the HIE means that the provider or organization is required to access patient medical records from the HIE portal and to pay a monthly subscription fee based on their provider type and organization size.
• Transmitting data means the provider or organization is required to pay a connection fee and send their patients’ data to the HIE.
• Note that all exemption criteria will be re-evaluated annually   

Provider Type   

• Domestic violence shelters and similar entities performing crisis intervention, sexual assault, transitional living, and safe home services are exempted from the transmit requirement but are required to utilize the HIE.  
• Dieticians, speech therapists, occupational therapists, physical therapists, audiologists, nurses (RNs and LPNs), and other licensed diagnostic medical providers — when working outside of a hospital, lab, home health, hospice, or nursing facility that is a non-prescribing provider — are granted a broad-based exemption from both transmitting and utilizing.  
• Providers who are retired, working in a free clinic, or working in an administrative, educational or other non-patient treatment role are granted a broad-based exemption for both transmitting and utilizing.  

Size of Practice   

• Independent, non-prescribing practitioners (e.g., licensed professional counselors, licensed marital and family therapists, and psychologists) who work in an organization of three or fewer licensed providers or who operate in a practice with 150 or fewer active unique patients per provider per year may be exempt from the transmit requirement but are required to utilize the HIE.
• Independent prescribing practitioners within a practice with 500 or fewer unique patients per provider per year may be exempt from the transmit requirement but are required to utilize the HIE.
• Independent dental providers with 500 or fewer unique patients per provider per year are exempt from the transmit requirement but are required to utilize the HIE.
• Independent chiropractors with 500 or fewer unique patients per provider per year are exempt from the transmit requirement but are required to utilize the HIE.
• Independent optometrists with 500 or fewer unique patients per provider per year are exempt from the transmit requirement but are required to utilize the HIE.
• Home health and private duty nursing organizations with 60 or fewer patients at any given time are exempt from the transmit requirement but are required to utilize the HIE.
• Hospice organizations serving 60 or fewer patients at any given time are exempt from the transmit requirement but are required to utilize the HIE.  
• Long-term care facilities with an average daily census of 60 or fewer patients are exempt from the transmit requirement but are required to utilize the HIE.   

Financial   

• Financial exemptions may be granted to those providers where the cost to participate would have a significant effect on their ability to operate their business. This includes costs such as connection fees, subscription fees and or other administrative costs.   

Technological 

• Technological exemptions apply to those providers that, 1) do not have an electronic health record; 2) utilize a vendor that has a technical limitation to transmit the data; or, 3) are required by law to obtain patient consent prior to transmitting, and the vendor the provider utilizes is not yet able to limit transmission to only those patients who have provided consent and/or lacks the ability to limit transmission based on a “sensitive” flag.