Hospitals will now have option of including advanced practice nurses, physician assistants, and pharmacists as part of the medical staff under new rules governing hospital participation in the Medicare program.
The change is one of many that officials at the Centers for Medicare and Medicaid Services made as part of their revision of the Medicare Conditions of Participation for hospitals and critical access hospitals. The goal of the overhaul is reduce unnecessary, obsolete, and burdensome regulations on hospitals and physicians.
The final regulation, which was released on May 10, also gives hospitals the added flexibility to use standing orders. Along with that change, CMS has added a requirement that the medical, nursing, and pharmacy staff must approve written and electronic standing orders, order sets, and protocols. The orders and protocols must be based on nationally recognized and evidence-based guidelines and recommendations.
The rule also eliminates some requirements that CMS officials now view as unnecessary or redundant.
CMS abolished the requirement for hospitals to maintain an infection-control log. Hospitals already are required to monitor infections through various surveillance methods. Similarly, hospitals will no longer be required to have a single director of outpatient services to supervise all outpatient departments in the hospital. Since hospitals already have directors for each of those departments, an overall director is duplicative, according to the new rules.
CMS estimates that the overall changes will save hospitals and critical access hospitals nearly $940 million in the first year and nearly $5 billion over the next 5 years. For instance, by allowing advanced practice nurses and other nonphysician providers to practice to the full extent of their state license, physicians will have more time to devote to complex patients, according to CMS.
Federal officials also released the Medicare Regulatory Reform rule, a final regulation that aims to eliminate similar burdensome and unnecessary rules related to providers and beneficiaries in the Medicare and Medicaid programs. That regulation includes a number of changes, including retiring older versions of electronic prescribing transactions for Medicare’s Part D prescription drug program and adopting newer versions. CMS estimates that this rule will save about $200 million in the first year.