On October 18, 2011, the Centers for Medicare & Medicaid Services (CMS) initiated two sets of regulatory reforms and finalized a third that are designed to improve transparency and allow providers to operate with increased efficiency. One set proposes updates to Medicare Conditions of Participation (CoPs) for hospitals and critical access hospitals (CAHs) and the second set addresses regulatory requirements for a broader range of Medicare and Medicaid health care providers and suppliers. The third set reduces regulatory burdens for ambulatory surgical centers (ASCs).
One of the proposed rules is designed to identify and eliminate duplicative, outdated and conflicting requirements for hospitals, ASCs, end-stage renal disease (ESRD) facilities, durable medical equipment suppliers and other Medicare/Medicaid regulated providers. Again, the goals of this rule are to decrease burdens to providers and improve patient care. Of the some two dozen proposed changes, particularly important is the elimination of the current Medicare requirement that automatically deactivates a provider or supplier who has not submitted a claim for 12 consecutive months. This reform will prevent a provider from inadvertently being barred from reenrolling in Medicare for a certain period of time. Savings from this reform alone are estimated to be $26.7 million annually.
CMS also finalized the rule which updates the conditions for coverage regulations for ASCs and simplifies the notification requirements for patients concerning their rights. More specifically, this rule removes the requirement regarding notifying a patient in advance of the date of their scheduled procedure. Now, ASC services can be provided on the same day that a physician’s referral is received.
If you have questions or concerns regarding the foregoing or would like additional information, please contact your regular Hall Render attorney, or Todd Selby at tselby@hallrender.com or 317.977.1440; Brian Jent at bjent@hallrender.com or 317.977.1402; or David Bufford at dbufford@hallrender.com or 502.568.9368.
