HHS reg changes to lab services, privileges aim to save billions

The federal government is making "significant progress" toward new rules that would save the healthcare industry billions of dollars, increase efficiency and alleviate administrative burdens on physicians, according to the Department of Health & Human Services.

A long list of rules--both proposed and final--address a range of issues, from privileging and credentialing regulations for in-person and telemedicine visits to duties and privileges of advanced practice nurses and physician assistants.

The agency continues to tout the potential cost-savings of its work. "Two of the proposed rules we published are expected to result in significant savings to the health industry," HHS wrote in its most recent update. "The first, a major revision to the Medicare Conditions of Participation for Hospitals, is likely to result in an estimated savings of close to $5 billion over five years. The second, Regulatory Provisions to Promote Program Efficiency, Transparency and Burden Reduction, may result in cost savings that approach $200 million during the first year."

HHS highlighted other cost-saving efforts in the report, including rules that would:

  • Permit laboratory services to operate on-site at critical access hospitals, saving roughly $15.8 million per year.
  • Allow hospitals to determine the total number of directors needed for its outpatient services, saving $300 million per year.
  • Allow hospitals to set their own policies on the duties and privileges of advanced practice nurses, physician assistants and other licensed non-physician practitioners in accordance with state rules, saving hospitals roughly $330 million per year.
  • Permit hospitals to integrate nursing service care plans into their overall interdisciplinary care plan, eliminating the requirement that nursing staff develop two care plans, saving an estimated $110 million per year.
  • Allow hospitals to use standing medical orders approved by the hospital's clinical leadership to advance the practice of evidence-based medicine, saving $90 million per year.

Other rules focus on giving patients easier access to information about their healthcare, including a proposed rule that would allow patients to more easily access their clinical lab test results.

HHS also made note of a review that's underway of a Food and Drug Administration rule for medication bar codes. Under the current rule, drug manufacturers must use a certain type of bar code to identify the drug, but since that rule was imposed, many more types of bar codes and bar code readers have hit the market. FDA will conduct an economic review to determine if the rule should be modified to include these new technologies, according to HHS.    

To learn more:
- read an overview of HHS' retrospective review project
- read HHS' January retrospective review report (.pdf)
- see a chart listing all of HHS' proposed and final rules (.pdf)
- read the American Hospital Association summary of the report