21st Century Cures Act, information blocking explained
The short answer
The 21st Century Cures Act information-blocking rule (45 CFR Part 171) prohibits healthcare providers, IT developers, and HIEs / HINs from engaging in practices that interfere with the access, exchange, or use of electronic health information. The rule is enforced by ONC and OIG, with civil monetary penalties up to $1 million per violation for IT developers and HIEs and disincentives for providers. Exceptions allow legitimate reasons to limit disclosure.
Key takeaways
What every reader should walk away with
Prohibits interference with EHI access, exchange, and use
Applies to providers, IT developers, and HIEs / HINs
CMPs up to $1M per violation for IT developers and HIEs; disincentives for providers
Eight exceptions allow legitimate reasons to limit disclosure
USCDI v3 defines the scope of EHI in the near term; full EHI definition applies long term
By the numbers
The data that defines this market
The eight exceptions
The rule provides eight exceptions to information blocking, practices that would otherwise look like blocking but are permitted because they serve a legitimate purpose. Examples: preventing harm, privacy, security, infeasibility, content and manner, licensing, fees, and health IT performance.
Sources & references
Where this analysis comes from
Frequently asked
Answers to the questions buyers ask
What is information blocking under the 21st Century Cures Act?
A practice, except as required by law or covered by an exception, that interferes with the access, exchange, or use of electronic health information. The rule applies to providers, health IT developers, and HIEs / HINs.
What are the penalties for information blocking?
For IT developers and HIEs / HINs: civil monetary penalties up to $1 million per violation, enforced by OIG. For providers: disincentives administered by CMS (such as reduced Medicare promoting interoperability score). Eight exceptions allow legitimate reasons to limit disclosure.
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This guide is reviewed and maintained by the InterScripts editorial team and reflects current customer engagements, federal program activity, and 2026 regulatory updates.