The Centers for Medicare and Medicaid Services announced a flood of regulatory-relief initiatives for providers last week amid news that congressional action on Medicare reform, including prescription drug coverage, won't occur until at least this fall.
In separate appearances, HHS Secretary Tommy Thompson and CMS Administrator Thomas Scully unveiled a number of regulatory rollbacks and steps to make future regulations more provider-friendly.
Chief among the announcements was the creation of "open door" policy committees, consisting of top CMS staffers and representatives from provider groups, which will meet monthly to discuss regulations that have troubled providers and to ensure that future rules aren't too burdensome.
Scully, speaking at a press conference, said the agency would hold regional "listening sessions" to hear providers' complaints about regulations and payment policies and create "expert teams" within CMS to simplify rules identified as too burdensome.
Provider groups gave the agency high marks for its efforts and said the changes are more than superficial.
"Secretary Thompson and (Scully) both believe very strongly that the HCFA of the past did not solicit enough input from the people that they regulate," said Laura Thevenot, executive vice president and chief operating officer of the Federation of American Hospitals, which Scully used to head. "They feel that if they brought some of those people to the table at the front end, they'd get a better product." Meanwhile, HHS Secretary Tommy Thompson, testifying before the House Energy and Commerce Committee, announced several moves to reduce the paperwork burden on providers, including streamlining the amount of quality data hospitals need to collect for patients treated in "swing beds," which can alternate between acute-care and skilled-nursing services.
Thompson also said he would lighten the load on Medicare HMOs by requiring them to credential providers only once every three years, rather than every two years as is now required.
The regulatory reform announcements came as momentum for a wider Medicare restructuring bill slowed on Capitol Hill. Senate Finance Committee Chairman Max Baucus (D-Mont.) said last week that his committee would not hold a vote on restructuring legislation until at least September because the committee couldn't agree on a draft measure. Yet provider groups said the Bush administration needed to continue its Medicare regulatory reform push to restore the trust of Congress and the industry as the administration prepares to lobby for its own restructuring initiative (July 16, p. 8).
In announcing the creation of the open-door committees, Scully also said CMS will reconsider a recently imposed policy to apply rules against patient dumping to hospital-owned off-site outpatient clinics that receive Medicare reimbursement at the same rates as hospital-based clinics.
Scully said CMS has begun requiring that those clinics comply with the Emergency Treatment and Active Labor Act, even though they don't provide emergency services. CMS requires such compliance because, as so-called "provider based" clinics, they are considered under Medicare law to be part of a hospital and thus deserve higher reimbursement than other stand-alone outpatient centers, he said.
The issue will be one of several reviewed by the open-door committee chaired by Tom Grissom, director of CMS' center for Medicare management, which oversees the fee-for-service program.
In yet another announcement, Thompson said HHS will be creating a rural task force to examine how HHS programs can better serve small and remote communities.