The Centers for Medicare & Medicaid Services plans to trim several “unnecessary” requirements for hospitals and other providers participating in Medicare, including emergency services readiness requirements as well as staff training for obstetrical services that had been brought during the tail end of the Biden administration.
The proposed rule’s Conditions of Participation (CoP) rollbacks, shared late Thursday (PDF), followed a “comprehensive review” CMS conducted to identify and eliminate “obsolete, outdated and excessively burdensome regulations.”
Removing these, the agency estimated, would save $320 million and free up 3.26 million hours of staff time for provider organizations.
Among the chief changes is a repeal of requirements finalized in the 2025 Outpatient Prospective Payment System (OPPS) and ASC Payment Systems rule that tasked hospital and critical access hospital emergency departments to be “continually prepared” to provide emergency screening or stabilization regardless of whether they provide relevant specialty services, which were made effective in July 2025.
The 2025 rule paired those with baseline staffing and care delivery standards, annual staff training and maternal quality assessment and performance improvement (QAPI) requirements around obstetric care, which are currently set to take effect on Jan. 1, 2027. CMS also proposed eliminating those requirements this week.
CMS under the prior administration had said these requirements would improve safety, quality and the timeliness of care delivery for pregnant women.
On the other hand, CMS’ new proposed rule does look to add a new obstetrics requirement for hospitals and critical access hospitals tied to the collection of birth tissue, “including standards for informed consent and policies and procedures to support families requesting their birth tissues for cultural, religious or personal reasons,” per a fact sheet.
Other proposed changes to the CoPs include clarification revisions to policies regarding distance-related eligibility for critical access hospital designation, and to implement an exemption from the distance eligibility requirements for some critical access hospitals.
Long-term care facilities would also see changes around COVID-19 vaccination education for staff and uptake for residents, as well as exemptions for existing facilities from newer room occupancy and bathroom facility standards. Among other changes are removals or slimdowns of respiratory illness data reporting requirements for multiple types of provider facilities.
The proposed rule will be open for public comment for 60 days. Among these, CMS said it is interested in hearing from stakeholders on additional requirements for participating providers, including flexibilities for physician supervision of certified registered nurse anesthetists, expanding the scope of practice of nurse practitioners and physician assistants in long-term care facilities, and reducing barriers for new transplant programs to achieve initial certification.