CMS Proposes to Cut Red Tape for Medicare Providers

Posted on September 18, 2018 by Jonathan Lips

The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule this week to relieve burden on healthcare providers by removing unnecessary, obsolete or excessively burdensome Medicare compliance requirements for healthcare facilities. 

CMS has posted a fact sheet on the proposed rule, along with an overview of the agency’s Patient’s Over Paperwork initiative. 

Following a 2017 Executive Order from President Trump, CMS conducted a comprehensive review of the Medicare conditions of participation for all provider types, including recently released regulations as well as long-standing requirements, to identify opportunities to produce burden reduction and cost savings for providers. 

Notably, the proposed rule addresses Emergency Preparedness, which CMS explains as follows: 

“We continually assess our Emergency Preparedness policies to ensure that facilities maintain access to services during emergencies, provide safety for patients, safeguard human resources, maintain business continuity and protect physical resources.  This proposed rule will continue to ensure that these expectation are met.  At the same time we are proposing to reduce the complexity of the requirements to ensure that providers are spending more time and resources on actual patient care. 

Emergency program: Give facilities the flexibility to review their emergency program every two years, or more often at their own discretion, in order to best address their individual needs. A comprehensive review of the program can involve an extensive process that may not yield significant change over the course of one year. Facilities may review the plan more frequently should significant changes become necessary as determined by the individual needs of the facility. The combination of all Emergency Preparedness requirements (policies and procedures, testing, communication plan) will continue to hold facilities accountable for their outcomes while allowing them more time to focus on their unique needs and specific circumstances. 

Emergency plan: Eliminating the duplicative requirement that the emergency plan include documentation of efforts to contact local, tribal, regional, State and federal emergency preparedness officials and a facility’s participation in collaborative and cooperative planning efforts. This information is already contained in other regulations requiring that these activities occur. 

Training: Give facilities greater discretion in revising training requirements to allow training to occur annually or more often at their own discretion.  Overly restrictive training requirements can have unintended consequences in preventing facilities from focusing their training efforts on what makes sense in unique circumstances. 

Testing (for inpatient providers/suppliers): Increasing the flexibility for the testing requirement so that one of the two annually-required testing exercises may be an exercise of the facility’s choice. While two annual tests are still required, flexibility is provided so that one of those training sessions can be done through various innovative methods such as simulations, desk top exercises, workshops or other methods that may best meet the needs of the facility and the patients that they serve. The second training must continue to be a full scale community exercise. 

Testing (for outpatient providers/suppliers): Revising the requirement for facilities to conduct two testing exercises to one testing exercise annually. Additional testing will be at the facilities’ discretion based on unique needs. This will allow facilities to modernize their testing to use innovative methods such as desktop drills and simulations.” 

We will track the progress of the proposed rule and work with LeadingAge national to coordinate comments in support of these proposed changes.