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New CMS Rule Provides Regulatory Relief for Providers

September 18, 2018

The Center for Medicare & Medicaid Services (CMS) released a new proposed rule designed to reduce unnecessary administrative burdens associated with Medicare’s health care facility compliance regulations. CMS projects savings of nearly $5.2 billion and reduction of 53 million hours of administrative burden through 2021.  

The proposal streamlines Medicare’s condition of participation, condition for coverage, and other requirements while maintaining a focus on providing high-quality health care. Changes proposed in this rule include: 

  • Emergency Preparedness:  The proposed rule affords facilities the flexibility to review their emergency plan every two years or more frequently; removes the duplicate requirements of contacting federal, state, and local emergency preparedness officials; and gives facilities more discretion around training frequency. 
  • Hospitals: The proposed rule allows multi-facility systems to unify their Quality Assessment and Performance Improvement and Infection Control Programs across multiple hospitals. The rule also allows a pre-surgery/procedure assessment instead of a comprehensive medical history and physical examination. 
  • Critical Access Hospitals, Rural Health Centers, and Federally Qualified Health Centers:  The proposed rule removes certain long-term care facility requirements that do not apply in swing bed settings due to the limited length of stay and changes the policy-and-procedure-review timeframe from annual to biennial. 
  • Ambulatory Surgery Centers:  The proposed rule eliminates the duplicative written transfer agreement requirement and the requirement that a qualified practitioner perform a comprehensive medical history or physical assessment prior to scheduled surgery. 
  • Transplant Centers:  The proposed rule eliminates Medicare’s “re-approval” requirement and other burdensome provisions in order to promote the efficient delivery of care to parents in need of organ transplants.
  • Hospice:  The proposed rule uses state licensure requirements for hospice aides to set training and competency requirements, incorporates drug management experts into routine interdisciplinary groups meetings, and allows hospice providers to provide more user-friendly education and communication about the use, storage, and disposal of controlled drugs.  

Additional provisions include: 

  • Expanding the method of ordering portable x-rays to include orders by telephone and electronic methods
  • Allowing religious institutions to tailor their discharge planning processes 

In partnership with the American Hospital Association, HAP has been advocating with CMS for regulatory relief to allow hospitals and health systems to focus on delivering high-quality care and improving patients' access to services. HAP applauds CMS's commitment to reduce the regulatory burden as hospitals and health systems strive to meet the increasingly complex needs of patients and work to reduce health care spending and costs. 

This blog by HAP CEO and President Andy Carter outlines the broad spectrum of federal regulatory relief sought by the Pennsylvania hospital community, including the provisions specified in this detailed “Red Tape Reduction Wish List.”

CMS will be accepting comments through November 2018. Please contact Kate Routledge, HAP’s senior director, compliance support, for more information.

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