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CMS Finalizes Omnibus Burden Reduction Rule to Remove Unnecessary Regulations


The rule aims to remove unnecessary, obsolete or excessively burdensome regulations.


In an effort to reduce administrative burden through its Patients over Paperwork initiative, the Centers for Medicare & Medicaid Services (CMS) today announced the Omnibus Burden Reduction (Conditions of Participation) final rule.

The Omnibus Burden Reduction rule aims to remove unnecessary, obsolete or excessively burdensome Medicare regulations for hospitals and other providers. These changes could reduce inefficiencies to help providers deliver value, high quality care and better outcomes for patients at the lowest cost.

“I’ve heard time and again that unnecessary regulations are increasing costs on providers and they are losing time with patients as a result,” said Seema Verma, MPH, CMS Administrator. “This final rule brings a common sense approach to reducing regulations and gives providers more time to care for their patients, while reducing administrative costs and improving health outcomes.”

The rule finalizes provisions from three proposed rules:

  • Regulatory Provisions to Promote Program Efficiency, Transparency and Burden Reduction (Omnibus Burden Reduction)
  • Hospital and Critical Access Hospital Changes to Promote Innovation, Flexibility and Improvement in Patient Care
  • Fire Safety Requirements for Certain Dialysis Facilities

The Omnibus rule focuses on eliminating burdensome processes by reducing certain required activities.

For example, in the past, orders for X-rays needed to be written and signed. Under the new rule, these orders can be completed in written form, on the phone or electronically.

The agency is also reducing the frequency of policy reviews and evaluations for rural health clinics and qualified health centers from once a year to every two years.

CMS also hopes to eliminate duplicative requirements, keeping patient safety in mind. One aspect of this is flexibility with emergency preparedness. While providers across care settings are required to review their preparedness plans annually, a proposal reduced requirements. Through a comment period, the agency found that the annual requirement is necessary for patient and resident safety, so the proposal was not finalized.

The Omnibus rule will streamline regulations to allow multiple hospitals in a system to employ a unified Quality Assessment and Performance Improvement program. The goal, CMS said, is to make it easier for hospitals to implement best practices and innovations among facilities to improve care quality more quickly. This could benefit small and rural hospitals, the agency added.

The rule also aims to strengthen the organ donation process by changing transplant center requirements — specifically for data submission — to give providers more flexibility and freedom to support those who need a transplant. Current regulations are burdensome and have led to some programs avoiding performing transplants for certain patients, leading to organs being discarded. Under the Omnibus rule, the requirements will be eliminated to reduce the number of discarded organs and increase the number available for transplantation to improve outcomes.

The finalized rule advances the Patients over Paperwork initiative by saving providers an estimated 4.4 million hours of time spent on paperwork, the agency claims. It also has the potential to save providers a projected $800 million annually, or $8 billion over the next decade, CMS said.

“Today, CMS is taking action at President Trump’s direction to ‘cut the red tape,’ bringing relief to America’s healthcare providers by reducing unnecessary burden, allowing them to focus on their top priority — patients,” the agency said.

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