On May 16, 2012, the Centers for Medicare & Medicaid Services (CMS) published a final rule, “Reform of Hospital and Critical Access Hospital Conditions of Participation.” This final rule was 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 CoPs are federal health and safety requirements ensuring high quality care for all patients.  Hospitals and CAHs must meet these conditions to participate in the Medicare and Medicaid programs.  The final rule is designed to reduce the regulatory burden on hospitals by the following:

•  Requiring that all eligible candidates, including APRNs and PAs, must be reviewed by the medical staff for potential appointment to the hospital medical staff and then allowing for the granting of all the privileges, rights, and responsibilities accorded to appointed medical staff members.
• Supporting and encouraging patient-centered care, through such changes such as allowing a patient or his or her caregiver/support person to administer certain medications (both those brought from the patient’s home and those dispensed by the hospital), and by allowing hospitals to use a single, interdisciplinary care plan that supports coordination of care through nursing services.
• Encouraging the use of evidence-based pre-printed and electronic standing orders, order sets, and protocols that ensure the consistency and quality of care provided to all patients by allowing nurses the ability to implement orders that are timely and clear.
• 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.
• Allowing CAHs the flexibility to affiliate with other providers, as well as using temporary entities, to address efficiencies and alleviate work force shortages so that they can provide safe and timely delivery of care to their patients.The final rule will be effective on July 16, 2012.

Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction: CMS-9070-F

On May 16, 2012, the Centers for Medicare & Medicaid Services (CMS) published a final rule of CMS regulations that have been identified as unnecessary, obsolete, or excessively burdensome on health care providers and beneficiaries. This final rule would increase the ability of health care professionals to devote resources to improving patient care, by eliminating or reducing requirements that impede quality patient care or that divert resources away from providing the delivery of quality patient care.

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 regulatory changes include:

• Revising which End Stage Renal Disease (ESRD) facilities are required to comply with National Fire Protection Agency Life Safety Code requirements. CMS estimates that this revision could save an estimated $108.7 million for the ESRD providers.
• 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.
•  Revising the definition of “donor document” to clarify that a valid donor document is any documented indication of an individual’s choice regarding his or her wishes concerning organ and/or tissue donation that was made by that individual or another authorized individual in accordance with any applicable State law.  This revision recognizes that individuals can express specific wishes concerning organ and/or tissues donation and are not limited to a decision to donate or not donate their organs and/or tissues after their deaths.  It also recognizes that the donor document must comply with any applicable State law.  It also recognizes that other individuals, such as a parent of a minor child, may make the donation decision for another individual, if it is in accordance with any applicable State law.

The final rule will be effective on July 16, 2012.

Additional Details for other Providers

List of Providers Effective by these rules