May 8—A new rule will eliminate some regulatory requirements opposed by hospitals and save Medicare providers an estimated $660 million each year.

The final rule, issued Wednesday by the Centers for Medicare & Medicaid services (CMS), lifted a regulation that would have required very small critical access hospitals, rural health clinics, and federally qualified health centers to retain physicians onsite under a prescriptive schedule.

“This provision seeks to address the geographic barriers and remoteness of many rural facilities and recognizes telemedicine improvements and expansions that allow physicians to provide many types of care at lower costs, while maintaining high-quality care,” CMS stated in a release.

The rule revised a CMS proposal that would have required each hospital to have its own medical staff, even in multihospital systems. The final rule allowed the use of a unified and integrated medical staff shared by multiple, separately certified hospitals within a hospital system.

The agency also rescinded a regulation that required hospital governing boards to include representation from a member of their medical staff, and replaced it with a requirement that the board periodically consult with the individual assigned responsibility for the organization and conduct of the hospital’s medical staff, or his or her designee.

Both the medical staff and board member changes were sought by hospital advocates.

Additional Rules Changes

Other changes included allowing registered dietitians and qualified nutritionists to order patient diets directly without requiring the preapproval of a physician or other practitioner. The change aimed to give physicians and other practitioners more time to care for patients, according to the release.

The rule also eliminated requirements that ambulatory surgical centers must meet to provide radiological services that are an integral part of their surgical procedures. It permitted trained nuclear medicine technicians in hospitals to prepare radiopharmaceuticals for nuclear medicine without the continuous presence of the supervising physician or pharmacist. The change will help speed services to patients, particularly during off hours, according to the release.

The new rule, which followed a May 2012 final rule cutting $1 billion worth of providers’ annual regulatory burden, was part of the Obama administration’s ongoing red-tape reduction effort.

The latest effort to cut federal healthcare red tape followed a March report from the American Action Forum that found Affordable Care Act rules imposed $6.8 billion in recurring annual costs.


Rich Daly is a senior writer/editor in HFMA’s Washington, D.C., office. Follow Rich on Twitter @rdalyhealthcare.

Publication Date: Thursday, May 08, 2014