On October 24, 2011, the Centers for Medicare & Medicaid Services (CMS) published three rules designed to reduce regulatory burdens on health care providers in conjunction with the President’s January 18, 2011 Executive Order 13563 entitled “Improving Regulation and Regulatory Review.” First, CMS has proposed reforming the requirements that hospitals and critical access hospitals (CAHs) must meet in order to participate in the Medicare and Medicaid programs. Among other things, the proposed rule would: eliminate requirements that bar hospital patients or their caregivers from administering certain medications; remove the requirement for a single Director of Outpatient Services; allow one governing body to oversee multiple hospitals in a single health system; allow hospitals to have a single, interdisciplinary care plan supporting coordination of care instead of a stand-alone nursing care plan; and allow CAHs to provide certain services, including laboratory and radiology services, under arrangement. CMS estimates that the rule would save hospitals and CAHs more than $940 million each year. 

A second proposed rule would make 14 specific reforms to regulations identified as unnecessary, obsolete, or excessively burdensome for health care providers and beneficiaries. For instance, the rule would: clarify which end stage renal disease (ESRD) facilities must comply with the full federal Life Safety Code requirements; revise the requirements for emergency equipment at ambulatory surgical centers (ASCs); eliminate the Medicare re-enrollment bar in instances when revocation of billing privileges is based solely upon the failure of a provider or supplier to respond timely to a revalidation request or other CMS information request; revise requirements related to deactivation of Medicare billing privileges; remove obsolete language related to initial determinations, appeals, and reopenings of Part A and Part B claims and entitlement determinations; remove duplicative language on ASC infection practices; update obsolete e-prescribing technical requirements to meet current standards; and remove outdated Medicaid personnel qualifications language for physical therapists and occupational therapists. CMS expects the rule will save almost $200 million in the first year. Comments on both proposed rules will be accepted until December 23, 2011. 

CMS also published a final rule that revises the ASC conditions for coverage (CfC) by, among other things, allowing patient rights information to be provided to the patient, the patient’s representative, or the patient’s surrogate prior to the start of the surgical procedure. CMS estimates that the rule will save ASCs $50 million per year. The rule is effective December 23, 2011.