CMS puts hospital board rule on hold

On second thought, the Centers for Medicare & Medicaid Services is reconsidering a medical staff rule that received strong objections from the American Hospital Association and other provider groups, according to AHA News Now.

After much criticism from AHA, CMS on Friday said it will reconsider the Conditions of Participation rule that requires hospitals to include a medical staff member on the hospital governing board. The hospital group suggested CMS snuck in the requirement in the May final rule, although it was not in the October 2011 proposed rule. AHA cited a number of reasons why it objected to having a medical staff member on the governing board: Elected boards may not choose a physician, some state laws prevent such conflicts of interest, public hospitals may have limitations on boards and investor-owned hospitals may prohibit such arrangements, according to HealthLeaders Media.

Although AHA has voiced its objections to the CMS rule, the American Medical Association has not, HealthLeaders reported. Rather, AMA supports having a member of the medical staff on a hospital's governing body, arguing that it would expand medical staff representation.

"While the corporate executives, attorney, civic leaders, and other non-clinician[s] who sit on the governing body often bring relevant expertise to the overall management of the hospital, as non-clinicians, they are not equipped to evaluate and guide patient care at the facility," James Madara, AMA executive vice president, said in the article. 

CMS officials say they acknowledged both sides. "We're aware of the concerns around this rule and are taking them seriously," CMS spokesman Brian Cook wrote in an email to HealthLeaders. "We are looking at how to avoid any unnecessary conflicts for facilities, while also allowing medical staff's perspective on quality of care to be heard by an organization's governing board."

Because of the number of comments and revisions, CMS likely won't publish guidance in time for the July 16 deadline--the date the final regulations are supposed to go into effect, according to the CMS memorandum.

In the meantime, accredited hospitals are not expected to revise standards or survey processes related to this requirement until CMS has addressed the issue completely, it said. In addition, surveyors shouldn't ding hospitals for deficiencies on this requirement.

"Given the complexity of the issues that have been raised, we are carefully reviewing the comments and will reconsider this requirement in future rulemaking. Therefore, surveyors should not interpret on their own the requirement concerning medical staff membership on the governing body and must not issue citations related to this specific provision," CMS said.

For more information:
- read the AHA News Now brief
- see the CMS memorandum (.pdf)
- here's the HealthLeaders article

Related Articles:
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AHA: CMS sticks to 'antiquated' medical staff structure
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