Does an actor have to provide all the EHI requested by a requestor to satisfy the Manner Exception?

Generally, yes, but it may depend on the circumstances.

The scope of EHI* for which the actor must fulfill a request for access, exchange, or use in order to satisfy the Manner Exception is determined by the scope of the request and thus by the requestor. This is true regardless of whether the actor seeks to fulfill the request consistent with the manner requested condition (see 45 CFR 171.301(a)), the alternative manner condition (45 CFR 171.301(b)), or a combination of the conditions.

If the requestor’s request is for access, exchange, or use of a subset of EHI that the actor can fulfill in the manner requested (45 CFR 171.301(a)), then the actor can satisfy the Manner Exception by providing access, exchange, or use of that subset of EHI in that requestor-specified manner so long as the actor’s practice in doing so is otherwise consistent with the Manner Exception (45 CFR 171.301).

By contrast, if the actor cannot reach an agreement with the requestor or is not technically capable of providing all of the requested EHI in a particular requestor-specified manner, then to satisfy the Manner Exception for the request the actor would need to use one or more additional alternative manners specified by the requestor (45 CFR 171.301(b)(1)(i) and (ii)) or agreed to by the requestor (45 CFR 171.301(b)(1)(iii)), working through manners in the priority order identified in the alternative manner condition, until the actor has made all requested EHI available to the requestor.

An actor might have the technical capability to satisfy the Manner Exception for only some of the EHI requested in the manner(s) the requestor specifies. In such instances, the actor may want to consider whether another exception may apply for the remaining EHI not fulfilled through the Manner Exception.

* EHI is defined for purposes of the information blocking regulations in 45 CFR 171.102. On and after October 6, 2022, the scope of EHI for purposes of the information blocking definition (45 CFR 171.103) is EHI as defined in 45 CFR 171.102 (89 FR 1199, 85 FR 70069).