New CMS Rule Cuts Regulatory Burdens

A final rule from the Centers for Medicare and Medicaid Services continues the process of reducing regulatory burdens across government agencies, stemming from a Presidential Executive Order issued in 2011.


A final rule from the Centers for Medicare and Medicaid Services continues the process of reducing regulatory burdens across government agencies, stemming from a Presidential Executive Order issued in 2011.

President Obama ordered agencies to implement an ongoing retrospective review of regulations to identify those that are obsolete, unnecessary, burdensome or counterproductive. A range of such regulations from CMS were eliminated in 2012 and the new rule adds more, including elimination of certain data reporting requirements. According to CMS, the new rule will save providers $3.2 billion over five years, and $8 billion including savings from the 2011 rule.

The requirements being eliminated result from Medicare hospital conditions of participation, known as CoPs. For instance, transplant centers have been required to notify CMS of certain changes in their programs, yet the centers have been submitting data that CMS routinely receives from other sources. “This creates unnecessary paperwork and burden on the transplant program and does not contribute to Federal oversight,” according to the rule. “We are eliminating this redundant data submission requirement.”

Other changes eliminate requirements of physician oversight, such as allowing registered dietitians and other clinically qualified nutrition professionals to order patient diets. Also, the presence of a physician or pharmacist is no longer required for off-hour nuclear medicine tests.

Critical access hospitals, rural health clinics and federally qualified health centers no longer need to heed a requirement that a physician be onsite at least once in every two-week period. The facilities, however, “will continue to be required to have a physician onsite for sufficient periods of time depending on the needs of the facility and its patients,” according to the rule. Critical access hospitals also no longer must develop patient care policies with the advice of at least one individual who is not a member of the CAH staff.

The rule also makes numerous changes to regulations under the Clinical Laboratory Improvement Amendments of 1988. Further, requirements that ambulatory surgery centers must meet to provide services have been reduced. The centers have been subject to full hospital requirements for radiology services. Now, they are subject only to requirements that reflect services that the centers are permitted to perform.

“We applaud the Centers for Medicare and Medicaid Services for providing hospitals with much needed relief in the Medicare rules for medical staffs and governing boards,” said the American Hospital Association in a written statement. “The new CMS interpretations ease regulatory burden and permit medical staffs and hospitals to work together to structure their boards and medical staffs in the way that best supports their missions and communities.”

The final rule is available here.

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