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Proposal expected to save U.S. healthcare facilities
$1.12 billion per year

The Centers for Medicare & Medicaid Services (CMS) recently announced a proposed rule that looks to remove, “unnecessary, obsolete or excessively burdensome Medicare compliance requirements” for healthcare facilities and providers. CMS cited a recent Health Affairs study that reported, in four common specialties, that U.S. physicians and their staff spend, on average, 15.1 hours per week on reporting quality measures, totaling 785 hours annually per physician. In addition to time spent, it costs these physicians, on average, $40,000 per year to report quality measures, totaling over $15.4 billion annually for all measured physicians. Eighty-one percent (81%) of practices reported that they expend more effort dealing with quality measures now than three years ago, and only 27 percent said current measures are representative of the quality of care. The proposed changes would remove unnecessary and burdensome “red tape.” CMS Administrator, Seema Verma stated, “[t]he changes we’re proposing will dramatically reduce the amount of time and resources that healthcare facilities have to spend on CMS-mandated compliance activities that do not improve the quality of care.” Additionally, according to CMS, the proposed changes would save providers an estimated $1.12 billion annually. The proposed rule provisions would:

  • Eliminate duplicative requirements on transplant program information;
  • Streamline hospital outpatient and ASC requirements for conducting comprehensive medical histories and physical assessments;
  • Allow multi-hospital systems to have unified and integrated Quality Assessment and Performance Improvement programs for all of their member hospitals;
  • Simplify the ordering process for portable x-rays and modernize the personnel requirements for portable x-ray technologists; and
  • Remove duplicative ownership disclosure requirements for Critical Access Hospitals.

CMS also noted that it is working at all levels to update and streamline its programs, in an effort to reduce the burdens that providers associate with provider audits. For example, CMS awards Recovery Audit Contracts with checks and balances in place to ensure that providers are not adversely impacted by the reviews.  Furthermore, CMS has moved more towards a targeted review and education process and simplified and clarified payment related documentation requirements in its manuals.

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