WASHINGTON, Feb. 4, 2013 – The Centers for Medicare & Medicaid Services (CMS) proposed new rules today that are intended to reform unnecessary, obsolete, or excessively burdensome requirements on hospitals and health care providers, many of which are located in rural areas.

The proposal would save nearly $676 million annually, and $3.4 billion over five years, according to Health and Human Services Secretary Kathleen Sebelius.

“We are committed to cutting the red tape for health care facilities, including rural providers,” said Sebelius.  “By eliminating outdated or overly burdensome requirements, hospitals and health care professionals can focus on treating patients.”

The proposed rule is designed to help health care providers to operate more efficiently by getting rid of regulations that are out of date or no longer needed.  Many of the rule’s provisions streamline the standards health care providers must meet in order to participate in the Medicare and Medicaid programs.

The changes reflect an understanding that “rural is potentially a different place and requires a different thought process,” explained Agriculture Secretary Tom Vilsack during a conference call with Sebelius and other stakeholders today.

For example, a key provision reduces the burden on very small critical access hospitals, as well as rural health clinics and federally qualified health centers, by eliminating the requirement that a physician be held to an excessively prescriptive schedule for being onsite once every two weeks.  This provision seeks to address the geographic barriers and remoteness of many rural facilities, and recognize telemedicine improvements and expansions that allow physicians to provide many types of care at lower costs, while maintaining high-quality care.

Among other provisions, the proposed rule would:

    Save hospitals significant resources by permitting registered dietitians to order patient diets independently, which they are trained to do, without requiring the supervision or approval of a physician or other practitioner.  This frees up time for physicians and other practitioners to care for patients.

    Eliminate unnecessary requirements that ambulatory surgical centers must meet in order to provide radiological services that are an integral part of their surgical procedures, permitting them greater flexibility for physician supervision requirements.

    Permit trained nuclear medicine technicians in hospitals to prepare radiopharmaceuticals for nuclear medicine without the supervising physician or pharmacist constantly being present, which helps speed services to patients, particularly during off hours.

    Eliminate a redundant data submission requirement and an unnecessary survey process for transplant centers while maintaining strong federal oversight.

As part of President Obama’s regulatory reform initiative, CMS issued final rules in May last year that also reduce burdensome or unnecessary regulations for hospitals and additional health care providers.  Those rules are saving nearly $1.1 billion across the health care system in the first year and more than $5 billion over five years, according to HHS.

Vilsack acknowledged that there are still barriers in hospice care and telemedicine that need to be overcome, but pledged that the two cabinet secretaries would keep working to address these issues.  

To view the proposed rule, visit: www.ofr.gov/inspection.aspx.

The comment period will be open Feb 7 through April 5.

To view the May 2012 final rules, visit:



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