On May 10, 2012, CMS released two final rules designed to reduce regulatory burdens on health care providers as part of the Administration’s ongoing regulatory review initiative. According to CMS, the regulations, will save approximately $1.1 billion across the health system in the first year and more than $5 billion over five years.  The rules are summarized below.

  • The first rule reforms requirements that hospitals and critical access hospitals (CAHs) must meet in order to participate in the Medicare and Medicaid programs. Among other things, the rule: allows one governing body to oversee multiple hospitals in a single health system; revises requirements for reporting of restraint-related deaths; provides flexibility to consider other practitioners (e.g., advanced practice registered nurses, physician assistants, and pharmacists) as eligible candidates for the medical staff; allows patients or their caregivers to administer certain medications; allows hospitals to have a single, interdisciplinary care plan including nursing and other disciplines or a stand-alone nursing care plan; revises the rules for standing orders and verbal orders; and removes the requirement for a single Director of Outpatient Services. The rule also allows CAHs to provide certain diagnostic and therapeutic services, including laboratory and radiology services and emergency procedures, under arrangement (rather than directly by CAH staff).
  • A second final rule make a series of reforms to regulations identified as unnecessary, obsolete, or excessively burdensome for providers and suppliers. For instance, the rule: clarifies which end stage renal disease facilities must comply with the full federal Life Safety Code requirements; streamlines requirements for emergency equipment at ambulatory surgical centers (ASCs); eliminates 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; removes obsolete language related to initial determinations, appeals, and reopenings of Part A and Part B claims and entitlement determinations; removes duplicative language on ASC infection practices; updates obsolete e-prescribing technical requirements to meet current standards; and removes outdated Medicaid personnel qualifications language for physical therapists and occupational therapists.

Both rules will be published May 16, 2012, and are effective on July 16, 2012.