CMS eases rules to cut doctors’ regulatory burdens
■ Changes to proposed regulations on Medicare conditions of participation will maintain self-governing medical staff requirements at hospitals and save nearly $1 billion.
By Charles Fiegl amednews staff — Posted May 18, 2012
Washington The Obama administration removed several duplicative and burdensome regulations from Medicare that will save physicians and hospitals more than $1 billion, officials announced on May 10.
The Centers for Medicare & Medicaid Services finalized two regulations that eliminated rules deemed to have adversely affected those participating in Medicare. In one regulation, billing privileges for physicians will be protected from unjust revocations. In another rule, CMS increased flexibility on governance boards at hospitals but protected the autonomy of medical staff at each facility.
“These changes cut burdensome red tape for hospitals and providers and give them the flexibility they need to improve patient care while lowering costs,” said acting CMS Administrator Marilyn Tavenner. “These final rules incorporate input from hospitals, other health care providers, accreditation organizations, patient advocates, professional organizations, members of Congress and a host of others who are working to improve patient care.”
CMS estimates that annual savings to critical access hospitals and other facilities will be $940 million a year. Other Medicare regulatory reforms would save an additional $200 million during the first year by promoting efficiency.
The American Medical Association had supported efforts to eliminate burdensome regulations, but it strongly opposed an initial plan to eliminate a requirement mandating single and separate medical staff for each hospital within multihospital systems. Medical staff self-governance is a basic federal requirement for accreditation and is mandated by some states.
“We are pleased that CMS adopted numerous AMA recommendations in the final Medicare conditions-of-participation rule, including a requirement that there be a single medical staff for each individual hospital,” said AMA President Peter W. Carmel, MD. “The AMA strongly supported this change from the previous proposal, which would have allowed a medical staff to be used over a multihospital system. A self-governed and autonomous medical staff at each hospital is imperative to ensure the health and safety of patients.”
Other CMS actions eliminated outmoded infection control instructions for ambulatory surgical centers, outdated Medicaid qualification standards for therapists and duplicative requirements for boards overseeing organ procurement programs.
CMS also no longer will bar physicians from re-enrolling in Medicare once enrollment and billing privileges are revoked because physicians failed to respond to revalidation requests, the agency said.
CMS did not finalize a proposal that would exempt certain physicians from enrollment deactivation when a doctor does not bill Medicare for 12 consecutive months. The agency concluded that allowing unused Medicare billing numbers to stay active would create a risk of identity theft and fraud.