CMS Proposes “Patients Over Paperwork” Regulatory Changes, Comment by Nov. 19

On Monday, the Centers for Medicare and Medicaid Services (CMS) announced its latest proposed rule focused on minimizing burdens on home health agencies, hospice providers, hospitals, skilled nursing facilities, and other health care entities. The proposed rule would save health care providers an estimated $1.12 billion a year, according to CMS.

“We are committed to putting patients over paperwork, while at the same time increasing the quality of care and ensuring patient safety and bolstering program integrity,” CMS Administrator Seema Verma said in a statement. “With this proposed rule, CMS takes a major step forward in its efforts to modernize the Medicare program by removing regulations that are outdated and burdensome.”

Hospice Changes

Proposed Hospice Medication Specialty Knowledge Policy Changes
CMS’ proposed rule included suggested changes to hospice requirements, most notably a change related to the requirement of having an individual with specialty knowledge of hospice medications on staff. The requirement “is no longer necessary for various reasons” and should be eliminated, according to CMS.

Proposed Change to Providing Medication Policies and Procedures to Patients
CMS is also proposing to replace the requirement that hospices provide a copy of medication policies and procedures to patients, families and caregivers with a requirement that hospices provide information regarding the use, storage, and disposal of controlled drugs to the patient, patient representative or family. The proposal calls for that information to be provided in a more user-friendly manner, as determined by each hospice.

Home Health Changes

Copy of Clinical Record Proposed Change
Monday’s proposed rule would remove the requirement that home health agencies provide a copy of clinical records to patients during the very next home visit following a request. Instead, agencies would have four business days to provide copies if patients or their families ask for them. Providing clinical record copies by the time of next visit is “not practical or even possible in some cases,” according to CMS.

Proposed Aide Full Competency Evaluation After Observed Deficient Skill Change
CMS’ proposed rule also calls for eliminating the requirement that home health aides receive full competency evaluations when supervisors visit in the field and identify deficiencies in caregiving ability. Currently, home health agencies must conduct—and aides must complete—full competency evaluations that assess all aide skills whenever an issue is observed.

In lieu of full competency evaluations, CMS is proposing that agencies need only retrain an aide in the observed deficient skill or skills, with aides likewise completing evaluations that are directly relevant to the issues at hand.

Proposed Change to Just Written Delivery and Elimination of Verbal Delivery of Patients’ Rights
The proposed rule also seeks to eliminate the requirement that home health agencies must provide verbal notification of all patient rights. Written notification, though, would still be required.

Comments to CMS

CMS will be accepting comments on this proposed rule change until November 19, 2018. The full text of the proposed changes can be found here.

Please contact Joy Cameron with any questions or concerns.