Reducing Obstacles to Access
As it does every year, CMS will review its payment rules for hospitals, physicians, nursing homes, and other health care providers and determine whether there are any regulatory requirements that may be eliminated without sacrificing patient care or safety. For example, CMS has already published a final rule for hospice care that would eliminate the requirement that the physician who performs a face-to-face encounter be the same physician to certify continued need for those hospice services. The proposal would permit a different physician to do the recertification, relieving hospice providers in underserved or rural areas from the onerous same-physician requirement. Similarly, CMS determined that a previous regulation requiring that physicians or non-physician practitioners to sign off on requisitions for the results of laboratory tests was not necessary and could delay delivery of these results to appropriate health care providers. As a result, CMS has notified providers that it will not enforce the requirement and is in the process of promulgating a new regulation on this provision.
CMS has approximately 80 reform proposals under review and development. CMS plans to present the proposed reforms to HHS leadership throughout the summer of 2011. These reforms may affect hospitals, physicians, home health agencies, skilled nursing homes, hospices, ambulance providers, clinical laboratories, intermediate care facilities, managed care plans, Medicare Advantage organizations, and rural health clinics. While most of these proposals are aimed at reducing barriers to effective patient care, some of them are aimed at transparency objectives—getting more and better online information to the public so that individuals can get the information they need easier and faster to make more informed decisions. CMS will try to complete these first phase reforms by the end of the calendar year.
In phase two, CMS intends to identify additional reforms for implementation next year. CMS will continue to look for ideas from its own staff as well as stakeholders and will use the opportunity in publishing proposed rules to ask the public to identify additional opportunities for regulatory reform. The cumulative effect of removing barriers to efficient and effective patient care will be substantial.
The list of candidate regulations currently proposed for review is at Appendix A.