September 27, 2019

CMS finalizes rules to cut regulatory burdens on hospitals, transplant centers

Daily Briefing

    CMS on Wednesday finalized two rules that eliminate several regulations that CMS has deemed duplicative or unnecessary and increases transparency in post-acute care facilities.

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    Regulatory burden final rule details

    The first final rule seeks to reduce regulatory burdens on providers at hospitals, transplant centers, and other facilities by eliminating certain Medicare requirements and regulations. CMS estimates the final rule will save providers an estimated 4.4 million hours of time and $843 million annually.

    For instance, the final rule decreases how often certain facilities have to conduct reviews of their emergency program from once annually to once every two years and decreases how often training must be conducted from once annually to once every two years.

    In addition, the final rule eliminates a requirement for health systems to have antibiotic stewardship programs, infection control programs, and Quality Assessment and Performance Improvement programs at each of their certified hospitals. Under the final rule, health systems are now allowed to have a single antibiotic stewardship program, infection control program, and Quality Assessment and Performance Improvement program for all their hospitals.

    For ambulatory surgical centers (ASCs), the final rule eliminates a requirement for ASCs to have written agreements to transfer patients to a hospital that meets certain Medicare requirements. Under the final rule, ASCs are instead required to periodically provide a local hospital with a written notice outlining the ASC's operations and patient population. However, ASCs under the final rule must continue to have a plan to effectively transfer patients who need emergency medical care from the ASC to a hospital.

    The agency also struck a requirement that physicians complete a comprehensive medical exam and physical within 30 days of a scheduled surgery, instead requiring ASCs to establish their own policy on when one would be appropriate.

    The final rule also allows transplant centers to submit less data for Medicare re-approval.

    Discharge planning final rule details

    The second final rule updates the discharge planning requirements for long-term care hospitals, critical access hospitals (CAHs), psychiatric hospitals, children's hospitals, and cancer hospitals.

    For instance, the final rule requires providers to take into account a patient's likelihood of needing post-hospital services during the discharge planning evaluation process. Providers under the final rule should also determine the availability of post-hospital services and a patient's access.

    Providers under the final rule also will be required to offer patients performance data on post-acute care facilities, as well as an electronic copy of their medical records.  

    In addition, the final rule requires hospitals to assess their discharge planning processes on a regular basis and requires home health agencies, critical access hospitals and other hospitals to help patients, families, and caregivers select a post-acute care provider when the patients are discharged or transferred to another provider (Brady, "Transformation Hub," Modern Healthcare, 9/25; Stein, Inside Health Policy, 9/25 [subscription required]; Cirruzzo, Inside Health Policy, 9/25 [subscription required]; CMS fact sheet, 9/25).

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