Health Care Alert: CMS Issues Rules Targeted At Reducing Compliance Burdens on Providers

Related Practices

Related Industries

Related News

Related Insights

Attorneys & Professionals

The Centers for Medicare and Medicaid Services (CMS) has issued two rulemakings aimed at alleviating procedural and administrative burdens on providers in response to the president's Executive Order 13563, Improving Regulation and Regulatory Review. The Executive Order directs each executive agency to reduce outmoded or unnecessarily burdensome rules in an effort to increase the ability of providers to devote resources to providing high quality patient care. The rules are slated to be published in the Federal Register on Wednesday, May 16, 2012, and will become effective July 16, 2012.

Regulatory Provisions to Promote Program Efficiency, Transparency and Burden Reduction

The first rule removes unnecessarily burdensome and obsolete requirements from the Medicare regulations. Some changes apply broadly to Medicare beneficiaries, providers and suppliers (e.g., removing obsolete claim determination and appeals provisions), while others are more specific to certain provider types (e.g., ESRD facilities and ASCs). CMS projects the overall cost savings to exceed $200 million in the first year, and approximately $630 million in the next five years. The major changes are set forth below.

Removes Unnecessarily Burdensome Requirements

Removes Obsolete Regulations

Reform of Hospital and Critical Access Hospital Conditions of Participation

The second rule also reduces unnecessary provider regulatory obligations, but focuses specifically on hospital and critical access hospital (CAH) Medicare CoPs. The rule seeks to permit flexibility while eliminating unnecessarily burdensome CoPs. CMS projects that these changes will reduce the total regulatory burden for hospitals and CAHs by nearly $940 million initially, and by almost $5 billion over the next five years. Set forth below is a summary of the major provisions.


This newsletter is for general information purposes and should not be regarded as legal advice. As always, please let us know if you want more information or have questions about how these developments apply to your situation.

IRS CIRCULAR 230 DISCLOSURE: In order to ensure compliance with requirements imposed by the U.S. Internal Revenue Service, we inform you that any federal tax information contained in this communication (including any attachments) is not intended or written to be used, and it cannot be used, by any taxpayer for the purpose of (i) avoiding penalties that may be imposed under the U.S. Internal Revenue Code; or (ii) promoting, marketing, or recommending to another person, any transaction or other matter addressed herein.