An actor's practice of limiting the content of its response to or the manner in which it fulfills a request to access, exchange, or use electronic health information will not be considered information blocking when the practice meets all of the following conditions.

1. (a) Content condition—electronic health information. An actor must respond to a request to access, exchange, or use electronic health information with—

   1. (1) USCDI. For the period before October 6, 2022, at a minimum, the electronic health information identified by the data elements represented in the USCDI standard adopted in § 170.213.
   2. (2) All electronic health information. On and after October 6, 2022, electronic health information as defined in § 171.102.

2. (b) Manner condition—(1) Manner requested.

   1. (i) An actor must fulfill a request described in paragraph (a) of this section in any manner requested, unless the actor is technically unable to fulfill the request or cannot reach agreeable terms with the requestor to fulfill the request.

   2. (ii) If an actor fulfills a request described in paragraph (a) of this section in any manner requested:

      1. (A) Any fees charged by the actor in relation to fulfilling the request are not required to satisfy the exception in § 171.302; and
      2. (B) Any license of interoperability elements granted by the actor in relation to fulfilling the request is not required to satisfy the exception in § 171.303.

      3. (2) Alternative manner. If an actor does not fulfill a request described in paragraph (a) of this section in any manner requested because it is technically unable to fulfill the request or cannot reach agreeable terms with the requestor to fulfill the request, the actor must fulfill the request in an alternative manner, as follows:

         1. (i) The actor must fulfill the request without unnecessary delay in the following order of priority, starting with paragraph (b)(2)(i)(A) of this section and only proceeding to the next consecutive paragraph if the actor is technically unable to fulfill the request in the manner identified in a paragraph.

            1. (A) Using technology certified to standard(s) adopted in part 170 that is specified by the requestor.

            2. (B) Using content and transport standards specified by the requestor and published by:

               (1) The Federal Government; or

               (2) A standards developing organization accredited by the American National Standards Institute.

            3. (C) Using an alternative machine-readable format, including the means to interpret the electronic health information, agreed upon with the requestor.
         2. (ii) Any fees charged by the actor in relation to fulfilling the request are required to satisfy the exception in § 171.302.
         3. (iii) Any license of interoperability elements granted by the actor in relation to fulfilling the request is required to satisfy the exception in § 171.303.

[85 FR 25955, May 1, 2020, as amended at 85 FR 70085, Nov. 4, 2020]