Practice Management Alert

Question: Will the recently announced burden reduction proposed rule affect independent practices like our single-clinician family practice?

Alabama Subscriber

Answer:  While the burden reduction proposed rule could still face major changes, the Centers for Medicare and Medicaid Services (CMS) keeps pursuing new ways of reducing burdens and cutting red tape.

“We heard that many of our quality measurements weren’t meaningful in actually measuring quality, so as a part of the Patients Over Paperwork Initiative, we revamped our quality measurements, and have called our new program Meaningful Measurements,” said CMS administrator Seema Verma during a Sept. 17, 2018, speech.

“We heard complaints about the Stark Law, EHRs, interoperability and E/M codes. We issued an RFI on Stark and we plan to revise our regulations, hopefully this year. We have made it clear that patients own their medical record and have made significant changes to make interoperability of the healthcare system a reality,” she said.

Verma also mentioned the reformation of E/M coding, and new recovery audit contracts (RAC audits), where CMS focused on streamlining the review process and documentation requirements.

“We are proposing a new rule that will make changes across the health care delivery system from hospitals, to surgery centers, transplants center, hospices, mental health centers and many more. Today’s rule is intended to ease the burden of regulation, while ensuring that we maintain a focus on integrity, quality and safety,” she said.

While the changes to Stark Law, electronic health records (EHRs), and evaluation and management (E/M) codes may have an effect on small practices, much of the new burden reduction proposed rule is focused on simplifying measures surrounding organ transplantation, adjusting hospital outpatient and ambulatory surgical center rules around physician determination of necessary information for individual patients, and adjustments in Quality Assessment and Performance Improvement (QAPI) for large hospital systems.

However, your practice could potentially be affected by the proposed simplification around measures for ordering portable X-rays and engaging radiology technicians.

To see more on this federal rule, visit: https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-19599.pdf. Public comments are being accepted through Nov. 19, 2018.