CHA News Article

CMS Proposes Changes to Emergency Preparedness and Other CoPs

The Centers for Medicare & Medicaid Services (CMS) has released the attached proposed rule intended to reduce regulatory burden for hospitals, critical access hospitals (CAHs) and other providers. CMS proposes changes to its conditions of participation (CoPs) — including its emergency preparedness CoPs — and conditions for coverage.

With respect to its emergency preparedness policies, CMS proposes to:

  • Give facilities the flexibility to review their emergency program every two years rather than annually, or more often at their discretion.
  • Eliminate a duplicative requirement that the emergency plan include documentation of efforts to contact local, tribal, regional, state and federal emergency preparedness officials, as well as participation in collaborative and cooperative planning efforts.
  • Give facilities greater flexibility in revising training requirements to allow training to occur annually, or more often at their discretion.
  • Increase flexibility for the inpatient provider testing requirement so that one of the two testing exercises required annually may be an exercise of the facility’s choice. 
  • Reduce the number of testing exercises outpatient providers are required to conduct annually from two to one.

For hospitals and CAHs, CMS proposes to:

  • Allow multi-hospital systems to have a unified and integrated Quality Assessment and Performance Improvement Program, as well as unified infection control programs, for all of its member hospitals.
  • Allow discretion on when an autopsy is indicated in certain instances, deferring to state requirements.
  • Allow hospitals the flexibility to establish a medical staff policy describing the circumstances under which a pre-surgery/pre-procedure assessment for an outpatient could be utilized instead of a comprehensive medical history and physical examination.
  • Clarify the requirement that allows psychiatric hospitals to use non-physician practitioners or doctors of medicine/doctors of osteopathy to document progress notes for patients.
  • Remove cross-references to requirements for long-term care facilities that do not apply to swing-bed providers because of the short time patients are in swing beds.
  • Reduce, from annual to biennial, the frequency at which CAHs must review their policies and procedures.
  • Remove the duplicative requirement for CAHs to disclose the names of people with a financial interest in the CAH, as this information is also collected outside of the CoPs.

The proposed rule also suggests changes for other providers and care settings, including rural health clinics, federally qualified health centers, ambulatory surgical centers, transplant centers, hospices, comprehensive outpatient rehabilitation facilities, community mental health centers, religious non-medical health care institutions and portable X-ray services. More details on those proposals are included in a CMS fact sheet.

CHA is currently reviewing the proposed rule and is pleased to see that CMS has further considered many issues that were unaddressed in previous rulemaking.  CHA looks forward to engaging members on this proposed rule and will make available a more detailed summary in the coming weeks. Comments on the proposed rule are due Nov. 19.