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  • Washington Highlights

    CMS Issues Final Rule on Hospital Burden Reduction

    Mary Mullaney, Director, Hospital Payment Policies

    The Centers for Medicare and Medicaid Services (CMS) Sept. 25 issued a final rule that modifies or removes numerous Medicare regulations that it deems to be unnecessary, obsolete, or excessively burdensome on hospitals and ambulatory surgical centers (ASCs). The AAMC submitted comments on the proposed rule. 

    In the final rule, CMS is removing the requirement that a History and Physical be performed within 30 days of a procedure and deferring to the ASC and physician’s clinical judgment to ensure that patients receive presurgical assessments tailored to the patient and type of surgery being performed. The treating physician will still be required to document any preexisting medical conditions and appropriate lab results in the medical record before, during, and after surgery. The AAMC supported this proposal.

    CMS removed the requirement that transplant centers must meet all data submission, clinical experience, and outcome requirements in order to obtain Medicare reapproval. The AAMC supported this proposal.

    Additionally, CMS is replacing the requirement that ASCs have written transfer agreements or privileges with the local hospital with a requirement that ASCs must periodically provide the local hospital with written notice of its operation and patient population served. The AAMC did not support this proposal.  These agreements outline the policies and procedures for patient transfers including necessary documentation to ensure a smooth transition between facilities. This allows for the receiving hospitals to better understand the treatment capacity of the ASC and be better equipped to receive patient transfers. Without such agreements, patients will likely be transported to emergency departments with limited information about the reason for transfer rather than being directly admitted to the hospital.