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CMS Seeks Comments to Progress Patients over Paperwork Initiative


The agency is looking for ways to relieve administrative burden and increase quality of care.


The Centers for Medicare and Medicaid Services (CMS) is seeking ideas from the public to continue the progress of its Patients over Paperwork initiative, including those that broaden perspectives on potential solutions to relieve administrative burden.

CMS is searching for ways to improve:

  • Reporting and documentation requirements
  • Coding and documentation requirements for Medicare or Medicaid payment
  • Prior authorization procedures
  • Policies and requirements for rural providers, clinicians and beneficiaries
  • Policies and requirements for dually enrolled beneficiaries
  • Beneficiary enrollment and eligibility determination
  • CMS processes for issuing regulations and policies

“Patients over Paperwork remains a top priority and a driving force in lowering healthcare costs,” CMS Administrator Seema Verma, MPH, said in an announcement.

Verma said that Patients over Paperwork has made strides in clearing complex, outdated and duplicative requirements that are time-consuming for clinicians and contribute little to the quality of care or patient health.

“Our goal is to ensure that doctors are spending more time with their patients and less time on administrative tasks,” she said.

Since its launch in 2017, Patients over Paperwork has served as a vehicle for CMS to reduce regulatory burden and maintain flexibility and efficiency in Medicare and Medicaid, according to the agency.

Before issuing the request for information, CMS received feedback on burdensome requirements from medical and patient communities through other requests for information, listening sessions and meetings with frontline clinicians, healthcare staff and patients. And more than 2,000 stakeholders across 23 states provided the agency with input.

Through Patients over Paperwork, CMS hopes to:

  • Improve quality and operational efficiency. A reduction in administrative burden can lead to ensuring patient safety and higher quality care. CMS said that is the aim of the Patient Driven Payment model, a classification system that applies to Medicare payments to skilled nursing facilities beginning in October 2019.
  • Simplify documentation and coding. The agency is working with providers and clinicians to modernize documentation requirements and billing codes to allow for more time with patients. This could decrease burnout and bolster the doctor-patient relationship. CMS confirmed changes to home health recertification and eliminated the need for physicians to include separate statements about how long home health services are needed. Initial prescriptions of immunosuppressive drugs are allowed to be shipped to alternate addresses to ensure timely access to the drugs.
  • Implement Meaningful Measures. CMS works with healthcare stakeholders through the Meaningful Measures initiative to identify and pursue high-priority areas for quality measurement and improvement to achieve better outcomes. Another goal of the program is to ensure transparent quality and cost information that provides value to empower consumers.
  • Change CMS culture. Centers at CMS are working to reduce burden through the federal rulemaking process, sub-regulatory guidance and policy updates. One team works to ensure CMS is minimizing burden cross the agency to more effectively serve its public stakeholders.

Comments on how to reduce administrative burden via Patients over Paperwork must be submitted by Aug. 12, 2019.

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