Easing Emergency Preparedness Regulatory Burdens Proposed by CMS

CMS continues to help hospitals impacted by the aftermath of Florence

No sooner had Monitor Monday signed off on Monday’s program with live reports from the areas ravaged by Florence, then the Centers for Medicare & Medicaid Services (CMS) published a notice that is intended to ease emergency preparedness regulatory burdens.

In the Federal Register posting “Medicare and Medicaid Programs; Proposed Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction,” CMS issued a proposed rule as part of reducing regulation and controlling regulatory costs.

In proposing to ease regulations CMS clarified that they were continuing to ensure that “facilities maintain access to services during emergencies, provide safety for patient, safeguard human resources, maintain business continuity and protect physical resources.” The stated intent of the proposed reduction is to reduce the complexity of the requirements. A summary of the proposed modification to Emergency Preparedness Conditions of Participation: (Source: CMS-3346-P)

  1. Emergency program: Give facilities the flexibility to review their emergency program every two years, or more often at their own discretion, in order to best address their individual needs.

CMS is emphasizing that facilities will still be held accountable, and that review of the plan may be necessary more frequently.

  1. Emergency plan: Eliminating the duplicative requirement that the emergency plan include documentation of efforts to contact local, tribal, regional, State and federal emergency preparedness officials and a facility’s participation in collaborative and cooperative planning efforts.

CMS indicated that this information is contained in other regulations.

  1. Training: Give facilities greater discretion in revising training requirements to allow training to occur annually or more often at their own discretion. 

CMS stated that overly restrictive training requirements can have unintended consequences in preventing facilities from focusing their training efforts on what makes sense for their facility and unique circumstances.

  1. Testing (for inpatient providers/suppliers): Increasing the flexibility for the testing requirement so that one of the two annually-required testing exercises may be an exercise of the facility’s choice.

CMS clarified that while two annual tests are still required (including a full scale community exercise), flexibility is provided so that one of those training sessions can be done through various innovative methods such as simulations, desk top exercises, workshops or other methods that may best meet facility needs based upon the population they serve.

  1. Testing (for outpatient providers/suppliers): Revising the requirement for facilities to conduct two testing exercises to one testing exercise annually.

CMS clarified that a facility can elect to do additional testing based upon their unique needs. Suggesting the use of innovative methods including desk top drills and simulations.

This proposed reduction in burden will likely be welcomed most by smaller outpatient providers who often find the regulatory burden of compliance with emergency preparedness disproportionate to their size and availability of resources. Is your facility subject the Emergency Preparedness Rule? Will these proposed changes lessen your regulatory burden and help put “Patients Over Paperwork?” Stay tuned to Monitor Monday where we will continue to report on this proposed rule.

Read the CMS summary notice on Medicare Burden Reduction. CMS also published a summary Press Release of the Proposed Rule. The proposed rule [CMS-3346-P] can be viewed at the Federal Register Reading Room. This link will change once the proposed rule is published in the Federal Register on 09/20/2018.



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Nancy J. Beckley, MB, MBA, CHC

Nancy Beckley is founder and president of Nancy Beckley & Associates LLC, providing compliance planning and outsourced compliance services to rehab providers in hospitals, rehab agencies, and private practices. Nancy is certified in healthcare compliance by the Healthcare Compliance Certification Board. She is on the board of the National Association of Rehabilitation Providers and Agencies. She previously served on the CMS Professional Expert Technical Panel for Comprehensive Outpatient Rehabilitation Facilities. Nancy is a familiar voice on Monitor Mondays, where she serves as a senior national correspondent.

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