On October 18, the Centers for Medicare & Medicaid Services (CMS) took steps to
reduce unnecessary, obsolete, or burdensome regulations on American hospitals
and healthcare providers. These steps would help achieve the key goal of
President Obama's regulatory reform initiative to reduce unnecessary burdens on
business and would save nearly $1.1 billion across the health care system in
the first year for a total of over $5 billion over 5 years.
CMS proposed two sets of regulatory reforms today, and finalized a third. All
are designed to improve transparency and help providers operate more
efficiently by reducing their regulatory burden. One set proposes updates to
the Medicare Conditions of Participation (CoPs) for hospitals and critical
access hospitals (CAHs). The second set addresses regulatory requirements for
a broader range of health care providers and suppliers who are regulated under
Medicare and Medicaid. CMS also finalized a third rule reducing regulatory
burden for ambulatory surgical centers (ASCs).
CMS estimates that annual savings to hospitals from the proposed revisions to
the Conditions of Participation could exceed $900 million in its first year as
hospitals increasingly use this new flexibility. The Medicare Regulatory
Reform rule could save up to $200 million in the first year. The final rule
for ASCs could generate an extra $50 million in savings per year.
Taken together, these three rules would reduce hospital and other healthcare
provider costs by nearly $1.1 billion the first year. These cost savings would
come directly from reduced regulatory burdens, and are not accompanied by
reimbursement reductions. As such, all of these savings would be available to
help providers improve the quality of care they provide to Medicare
beneficiaries and all Americans.
Background
The proposed rules were developed through a retrospective review of existing
regulations called for by President Obama's January 18, 2011 Executive Order
13563, to "modify, streamline, or repeal" regulations which impose unnecessary
burdens, including on hospitals and other providers that must comply with
requirements under Medicare.
The rules take into consideration numerous burden reduction recommendations
from hospitals, critical access hospitals, and patient advocates, among others.
Medicare Conditions of Participation
The Conditions of Participation are federal health and safety requirements
ensuring high quality care for all patients. Hospitals and critical access
hospitals must meet these conditions to participate in the Medicare and
Medicaid programs. The proposed rule is designed to reduce the regulatory
burden on hospitals by the following:
* Eliminating burdensome requirements that do not permit hospital
patients or their caregivers/support persons to administer certain medications.
* Allowing hospitals to determine the best ways to oversee and manage
outpatients by removing the unnecessary requirement for a single Director of
Outpatient Services.
* Increasing flexibility for hospitals by allowing one governing body to
oversee multiple hospitals in a single health system.
* Enabling hospitals to have a single, interdisciplinary care plan that
supports coordination of care instead of requiring a separate stand-alone
nursing care plan.
* Allowing CAHs to provide certain services, including laboratory and
radiology services, under arrangement.
Medicare Regulatory Reform
The Medicare Regulatory Reform rule would identify and begin to eliminate
duplicative, overlapping, outdated, and conflicting regulatory requirements for
health care providers and suppliers, including hospitals, ambulatory surgical
centers, end-stage renal disease facilities, durable medical equipment
suppliers, and a host of other healthcare providers and suppliers regulated
under Medicare and Medicaid. The goal of this proposed rule is to both reduce
regulatory burdens and help providers improve care for patients.
This rule would help reduce unnecessary burdens on health care providers,
allowing them to dedicate more resources to improving patient care. Some of
the more than two dozen proposed regulatory changes include:
* Eliminating obsolete regulations, including expired OMB paperwork
control numbers; outmoded infection control instructions for Ambulatory
Surgical Centers; outdated Medicaid qualification standards for physical and
occupational therapists; and
duplicative requirements for governing bodies of Organ Procurement
Organizations.
* Clarifying which higher risk End Stage Renal Disease (ESRD) facilities
are required to comply with the full federal Life Safety Code requirements.
CMS estimates that this burden reduction could save an estimated $108.7 million
for the ESRD program.
* Eliminating the current Medicare requirement that automatically
deactivates a provider or supplier who has not submitted a claim for 12
consecutive months, keeping providers from inadvertently being barred from
re-enrolling in Medicare for a certain
period. Savings from this regulatory reform are projected to be $26.7
million annually.
* Eliminating the specific list of emergency equipment Ambulatory
Surgical Centers must have on hand, and allowing facilities, in conjunction
with medical staff and their governing bodies, to develop policies and
procedures that specify emergency
equipment appropriate to the services they provide.
* Replacing inflexible time-limited agreements which govern Intermediate
Care Facilities for the Mentally Retarded participation in Medicaid, with
open-ended agreements and reducing states' paperwork burden by requiring
inspection of these facilities
once a year. The regulation also takes up a recommendation from
stakeholders to replace the term "mental retardation" with the term
"intellectual disability," which has gained wide public acceptance in recent
years.
* Updating e-prescribing technical requirements so Medicare Prescription
Drug Plans meet current standards.
Regulatory Reform for Ambulatory Surgical Centers
This announcement also includes a final rule from CMS that would update the
conditions for coverage regulations for Ambulatory Surgical Centers (ASCs),
based on a proposed rule CMS issued in April 2010.
This new final rule simplifies requirements that ASCs must follow in notifying
patients about their rights. Specifically, the final rule will allow ASCs to
provide the patient, the patient's representative, or the patient's surrogate
with patient rights information prior to the start of the surgical procedure.
Before this final rule
(CMS-3217-F<http://www.gpo.gov/fdsys/pkg/FR-2011-10-24/html/2011-27171.htm>),
ASCs were required to notify patients in advance of the date of the procedure.
This caused particular logistical problems and inconveniences for patients who
needed ASC services on the same day they received a physician referral.
For More Information
To view the proposed rules, please visit
CMS-9070-P<http://www.gpo.gov/fdsys/pkg/FR-2011-10-24/html/2011-27176.htm> or
CMS-3244-P<http://www.gpo.gov/fdsys/pkg/FR-2011-10-24/html/2011-27175.htm>. To
submit a comment, visit www.regulations.gov<http://www.regulations.gov>, enter
the ID number CMS-9070-P or CMS-3244-P, and click on "Submit a Comment."
For additional information on hospital and critical access hospital Conditions
of Participation, visit
http://www.cms.gov/CFCsAndCoPs/06_Hospitals.asp<http://links.govdelivery.com:80/track?type=click&enid=bWFpbGluZ2lkPTE0ODI3MjgmbWVzc2FnZWlkPVBSRC1CVUwtMTQ4MjcyOCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2ODE3MDcmZW1haWxpZD1saXNhLnNtaXRoQGNtcy5oaHMuZ292JnVzZXJpZD1saXNhLnNtaXRoQGNtcy5oaHMuZ292JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&103&&&http://www.cms.gov/CFCsAndCoPs/06_Hospitals.asp>
The proposed rule also invites public comment on a broad range of
recommendations to improve patient safety and hospital quality of care beyond
those specified in the Conditions of Participation.
CMS' final rule on Ambulatory Surgery Centers was effective on Tuesday, October
18, 2011. More information about ASCs is online at
http://www.cms.gov/CFCsAndCoPs/16_ASC.asp<http://links.govdelivery.com/track?type=click&enid=bWFpbGluZ2lkPTE0ODI3MjgmbWVzc2FnZWlkPVBSRC1CVUwtMTQ4MjcyOCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2ODE3MDcmZW1haWxpZD1saXNhLnNtaXRoQGNtcy5oaHMuZ292JnVzZXJpZD1saXNhLnNtaXRoQGNtcy5oaHMuZ292JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&104&&&http://www.cms.gov/CFCsAndCoPs/16_ASC.asp>.
The Department of Health and Human Services also has launched the Partnership
for Patients initiative, a national collaboration with hospitals, employers,
physicians, nurses, patient advocates, and State governments to protect patient
safety, provide better care, and reduce costs. For more about the Partnership
for Patients, go to:
http://www.healthcare.gov/center/programs/partnership/index.html<http://links.govdelivery.com:80/track?type=click&enid=bWFpbGluZ2lkPTE0ODI3MjgmbWVzc2FnZWlkPVBSRC1CVUwtMTQ4MjcyOCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2ODE3MDcmZW1haWxpZD1saXNhLnNtaXRoQGNtcy5oaHMuZ292JnVzZXJpZD1saXNhLnNtaXRoQGNtcy5oaHMuZ292JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&105&&&http://www.healthcare.gov/center/programs/partnership/index.html>
-------------------------------------------------
Vaccination is the Best Protection Against the Flu
The Centers for Disease Control and Prevention is encouraging everyone 6 months
of age and older to get vaccinated against the seasonal flu. The risks for
complications, hospitalizations, and deaths from the flu are higher among
individuals aged 65 years and older. Medicare pays for the seasonal flu
vaccine and its administration for seniors and others with Medicare with no
co-pay or deductible. And remember, vaccination is particularly important for
healthcare workers, who may spread the flu to high-risk patients; don't forget
to immunize yourself and your staff. Protect your patients. Protect your
family. Protect yourself. Get the Flu Vaccination - Not the Flu.
Remember - The flu vaccine plus its administration are covered Part B benefits.
CMS has posted the 2011-2012 seasonal flu vaccine payment limits at
http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp. Note that
the flu vaccine is NOT a Part D-covered drug.
For more information on coverage and billing of the flu vaccine and its
administration, as well as related educational provider resources, visit
http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp and
http://www.cms.gov/immunizations.
------------------------------------------------------
Note: If you have problems accessing any hyperlink in this message, please
copy and paste the URL into your Internet browser.
If you know someone who would like to subscribe to a Medicare Fee-For-Service
(FFS) provider listserv, go to
(http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf).
If you would like to unsubscribe from a specific provider listserv, please go
to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the
appropriate listserv.
Please DO NOT respond to this email. This email is a service of CMS and routed
through an electronic mail server to communicate Medicare policy and
operational changes and/or updates. Responses to this email are not routed to
CMS personnel. Inquiries may be sent by going to
(http://www.cms.gov/ContactCMS). Thank you.
