Two new rules from the Centers for Medicare and Medicaid Services revise patient discharging requirements for hospitals and reduce what the agency called unnecessary or obsolete administrative Medicare requirements for providers.
In the first rule, issued Sept. 26, hospitals will be required to update discharge planning processes to include the goals and treatment preferences of patients. CMS will also require hospitals to provide patients access to their medical records after discharge, including if they request for them to be an electronic record.
The new requirements apply to inpatient rehabilitation facilities, home health agencies and multiple hospital types, including long-term care hospitals, critical access hospitals and psychiatric hospitals. The requirements must be met if facilities want to participate in both Medicare and Medicaid, according to the agency.
CMS' rule implements provisions outlined in the 2014 Improving Medicare Post-Acute Care Transformation Act, or IMPACT Act. The provisions include requiring facilities to give patients quality and performance metrics when they are selecting a possible post-acute care provider to be discharged to. CMS also expects facilities to document how they are accounting for patients' treatment goals and preferences.
Under the IMPACT Act, long-term care hospitals, skilled nursing facilities, inpatient rehabilitation facilities and home health agencies must submit standardized data to CMS. The required reporting data included quality measures and patient assessment records, according to CMS.
CMS said in a Sept. 26 statement that hospitals and critical access hospitals were already following most of the revised discharge planning requirements, except for the ones outlined in the IMPACT Act. The discharge rule was first proposed by the agency in November 2015.
A second rule finalized by CMS aims to reduce administrative and regulatory requirements that were "unnecessary, obsolete, or excessively burdensome," according to a Sept. 26 statement from the agency. The finalized rule combines provisions from three proposed rules, two from 2016 and one from September 2018.
"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," CMS Administrator Seema Verma said in the statement.
The provisions update a long list of Medicare requirements for multiple facility types, including revising hospital transfer requirements for ambulatory surgery centers, removing certain data reporting requirements for transplant centers seeking Medicare reapproval, and allowing hospital systems to use one quality and performance assessment improvement program.
CMS projects the finalized rule to save providers $800 million annually.
