CMS proposes new Medicare compliance rules: 7 things to know

CMS issued a proposal  to update  its Medicare compliance requirements Sept. 17, which includes eliminating duplicative ownership disclosures for critical access hospitals and other requirements that could save healthcare providers more than $1 billion annually.

Seven things to know about the proposed changes:

1. Organ transplants. Under CMS' proposed update, transplant centers would no longer have to re-submit clinical experience, outcomes and other data to receive Medicare approval. CMS said the provision aims to reduce the number of organs that go unused due to the re-submission process.

2. Medical histories and physical assessments. The proposed rule establishes a medical staff policy detailing when a pre-surgery/pre-procedure assessment for an outpatient could be utilized. The current requirement is to conduct a comprehensive medical history and physical examination on each patient within 30 days of the scheduled surgery.

3. Infection control. CMS proposed allowing health systems with multiple hospitals to have unified and integrated Quality Assessment and Performance Improvement and unified infection control programs for member hospitals. 

4. X-rays. CMS proposed allowing portable X-ray services to be ordered in writing, by telephone or by electronic methods. The agency said it also proposed replacing four training and education requirements for technologists with one qualification that focuses on the technologist's skills and abilities.

5. Ownership disclosure. CMS proposed removing a duplicative requirement for critical access hospitals to disclose individuals who have a financial interest in the facility.

6. CMS explains reasoning. CMS said the above provisions in the proposed rule are designed to remove "unnecessary, obsolete or excessively burdensome" Medicare compliance requirements to make it easier for healthcare facilities. It estimates the updates would save healthcare providers about $1.12 billion each year. The proposed rule also includes two other types of proposals — "streamlining/simplification" and "reducing frequency/timelines where appropriate."

7. Comments on the proposed rule are due Nov. 19.

Read the full proposed rule here.


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