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REGULATORY REVIEW


Trump Administration Works to Reduce Regulatory Burden Feedback requested to guide future action BY ALEX TAIRA


In September 2019, the Centers for Medicare & Medicaid Services (CMS) announced the finalization of burden


reduction measures the ASC commu- nity has long requested: (1) remov- ing the requirement that ASCs have a transfer agreement with a hospital or that all ASC physicians have admit- ting privileges with a local hospital, (2) replacing the requirement regard- ing history and physical assessment (H&P) with a new standard based on a clinician’s clinical judgment and (3) revisions to emergency prepared- ness requirements. These provisions first appeared in a September 2018 proposed rule titled “Regulatory Pro- visions to Promote Program Effi- ciency, Transparency, and Burden Reduction,” to which ASCA submit- ted comments supporting the propos- als. The ensuing finalization repre- sents a major regulatory win for the ASC industry. The Regulatory Review column in the January 2020 issue of ASC Focus magazine will discuss all the changes that impact ASCs. For more informa- tion, visit ascassociation.org/2019- burden-reduction-rule. Another provision that might reduce some burden for ASCs was a July 2019 proposed rule aimed at reg- ulations issued under Section 1557 of the Patient Protection and Afford- able Care Act (ACA). That proposed rule suggests eliminating a require- ment that providers distribute non- discrimination notices and “tagline” translation notices in 15 languages to patients and customers.


Background


On January 20, 2017, shortly after being sworn in as the 45th


president and


shortly before attending his inaugural ball, President Donald Trump signed Executive Order 13765: Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal. That the order came quickly was no surprise; repeal of the ACA had been a central issue in the 2016 election cycle and would con- tinue to dominate political news for months to come. The order, however, did not just lay out a mandate for ACA repeal. In Section 2, it also directs the secretary of Health and Human Ser- vices (HHS) and other agencies to exercise all authority to “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a . . . regulatory burden on indi- viduals, families, healthcare providers, health insurers” and others. This directive is perhaps the defin- ing theme of healthcare initiatives in


TRACK THE LATEST REGULATORY AND LEGISLATIVE NEWS FOR ASCs


Visit ASCA’s website every week to stay up to date on the latest government affairs news affecting the ASC industry. Every week, ASCA’s Government Affairs Update newsletter is posted online for ASCA members to read. The weekly newsletter tracks and analyzes the latest legislative and regulatory developments concerning ASCs.


ascassociation.org/ GovtAffairsUpdate


24 ASC FOCUS NOVEMBER/DECEMBER 2019| ascfocus.org


the Trump administration. In almost every facet of the industry the admin- istration has sought to remove regu- latory barriers,


giving stakeholders


opportunities to provide input on ways federal regulations can be reshaped to reduce the compliance burden. On January 31, 2017, less than two weeks into office, the president held a listening session with pharmaceutical industry leaders. There, he promised attendees that he would cut regula- tions to encourage companies to bring jobs back to the US. On February 28, before a joint session of Congress, the president asserted that the adminis- tration had already taken “a historic effort to massively reduce job crush- ing regulations,” delivering the now famous mandate that any new regu- lation must involve the concurrent elimination of two old regulations. With the administration now more than halfway into its four-year term, it is worthwhile to examine its major regulatory burden reduction actions thus far, including some that directly affect ASCs.


Patients Over Paperwork In July 2017, speaking at the National Governor’s Association Meeting, the newly confirmed administrator of the Centers for Medicare & Medicaid Ser- vices (CMS) Seema Verma announced that CMS would be starting a “major deregulation initiative that will make it easier for healthcare providers and states to spend more time and resources focusing on delivering high-quality care and less time and resources trying to comply with complex regulations.” The initiative, called “Patients Over Paperwork,” was unveiled in October 2017 on a stakeholder call with more than 30 industry groups. On the call,


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