CMS eliminates outdated rules, projects provider savings of $660M a year

Hospitals will save approximately $660 million a year thanks to a new government rule that removes unnecessary, obsolete or burdensome regulations, according to the Centers for Medicare & Medicaid Services (CMS).

The reforms, announced yesterday in a final rule, eliminates requirements that hinder hospitals or other healthcare organizations from providing high-quality patient care, the agency said in an announcement. CMS estimates organizations will save roughly $3.2 billion over the next five years as a result of the new rule. In addition, it projects that combined with President Barack Obama's "regulatory look-back" executive order, the two rules will save healthcare providers $8 million over the course of five years.

"By eliminating stumbling blocks and red tape we can assure that the healthcare that reaches patients is more timely, that it's the right treatment for the right patient, and greater efficiency improves patient care across the board," said CMS Administrator Marilyn Tavenner in the announcement.

Key provisions of the rule will:

Eliminate the requirement that physicians who work at very small critical access hospitals (CAHs), rural health clinics and federally-qualified health centers (FQHCs) follow a strict onsite schedule. CMS expects the provision will address geographic barriers and remoteness of rural facilities.

Reduce requirements for radiology services in ambulatory surgical centers (ASCs). Instead of following full hospital requirements for radiology services, ASCs will only abide by the limited services they are allowed to perform that are essential to their surgical procedures. The changes will allow them to have greater flexibility of physician supervision requirements.

Provide registered dietitians with privileges. Registered dietitians and other clinically qualified nutrition professionals will be able to order patient diets under the hospital conditions of participation. CMS says this provision frees up physician time because registered dietitians can now order patients diets directly without the preapproval of a physician or other practitioner.

Allow trained nuclear medicine technicians in hospitals to prepare radiopharmaceuticals off-hours without a supervising physician or pharmacist present. The agency says this will speed services to patients.

Reclassify hospital swing-bed services. The revision will allow a CMS-approved accrediting organization to evaluate an accredited hospital's compliance with swing-bed requirements. The agency says the change will reduce the burden on hospitals because they no longer need to undergo an additional state survey specifically for swing-bed approval.  

Eliminate the need for a CAH to develop patient care policies with the advice from at least one member who is not on the CAH staff. This outdated requirement is a challenge to comply with because of the amount of time it takes for someone to become familiar with CAH operations, high turnover and expense, according to CMS.

Remove the requirement that a physician be on-site at CAHs, rural health clinics and FQHCs at least once every two weeks. This provision is a particular challenge for organizations in extremely remote areas. Telemedicine services now allow physicians to provider certain types of care to remote facilities.

To learn more:
- here's the rule (.pdf)
- read the announcement
- here's the executive order (.pdf)

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