On May 7, 2014, CMS issued CMS-3267-F, which finalizes reforms to various regulatory provisions that CMS identified as unnecessary, obsolete, or excessively burdensome.  CMS estimates that these changes will save affected entities approximately $660 million annually. 

The final rule is part of CMS’s efforts under Executive Order 13563.  Signed in early 2011, Executive Order 13563 called on agencies to conduct a retrospective review of rules that may be outmoded, ineffective, insufficient, or excessively burdensome.  According to CMS, the final rule will improve patient care “by eliminating or reducing requirements that impede quality patient care or that divert resources away from providing high quality patient care.”  Some of the changes under the final rule include the following:

• Elimination of the requirement that Ambulatory Surgical Centers (ASCs) comply with the full hospital requirements for radiology services even though ASCs are only permitted to provide limited radiologic services.  Going forward, the requirements for ASCs will be limited to only those services that ASCs are permitted to perform.

• Critical Access Hospitals (CAHs) will no longer be required as part of the Conditions of Participation (CoPs) to develop patient care policies with the advice of a non-staff member.

• A physician will no longer be required to be present at CAHs, Rural Health Clinics (RHCs), and Federally Qualified Health Centers (FQHCs) once during every two-week period.  CMS is eliminating this requirement in light of the burden it places on providers in extremely remote areas and in areas with a shortage of health care professionals.

• CMS is clarifying that a hospital’s medical staff must be composed of doctors of medicine or osteopathy, but that it may also include, in accordance with State laws (including scope-of-practice laws), other categories of physicians and non-physician practitioners who are determined to be eligible for appointment by the governing body.

• CMS is revising the definition of “physician” in the RHC and FQHC regulations to conform to the definition of “physician” found in the Medicare payment regulations to eliminate any possible confusion resulting from differing definitions.

• CMS is revising the hospital outpatient services CoP to allow practitioners who are not on the hospital’s medical staff to order hospital outpatient services for their patients when authorized by the medical staff and allowed by State law.

Reporter, Isabella Edmundson, Atlanta, +1 404 572 3527, iedmundson@kslaw.com.