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REGULATORY REVIEW


Verma noted that CMS had been aver- aging 58 pieces of regulation per year, a pace that had caused providers to commit undue time and resources to regulatory compliance. In the two years since its release


“Patients Over Paperwork” has been more of a policy umbrella than a focused program, with many actions fitting into its purpose but few defined goals or timelines. The first major piece of regulation released under the initiative was the 2018 Quality Pay- ment Program (QPP) and Physician Fee Schedule (PFS) Final Rule. That rule delineated the structure for the sec- ond year of Medicare’s newly imple- mented value-based payment system for physicians. Amid concerns about complying with what is widely consid- ered a broad, confusing new payment


system, Verma finalized a number of new flexible reporting requirements, including allowing physicians to report in “virtual groups,” hardship exemptions, and removing downward payment adjustments for provider practices that meet minimum quality reporting requirements.


The trend of creating more flex-


ible regulatory requirements contin- ued in 2018 under new HHS Secre- tary Alex Azar. In March 2018, CMS issued a Notice of Proposed Rule- making (NPRM) that included a pro- posal allowing states relief from cer- tain Medicaid data monitoring if a certain percentage of their enrollees were enrolled in a Medicaid managed care plan. The following month, the FY 2019 Inpatient Prospective Pay- ment System (IPPS) Proposed Rule


contained the elimination of 25 dupli- cative quality measures, a move CMS projected would cause a reduction of 2 million burden hours for hospital pro- viders. An October 2018 press release from Verma contained a CMS projec- tion of $5.2 billion in savings from 2018 to 2021 due to new CMS burden reduction proposals. The Trump administration has continually requested feedback on further actions they could take to reduce the regulatory burden on pro- viders. Please write Alex Taira if you have suggestions for burden relief mechanisms that ASCA can suggest to federal regulators.


Alex Taira is ASCA’s regulatory policy and research manager. Write him at ataira@ ascassociation.org.


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ASC FOCUS NOVEMBER/DECEMBER 2019| ascfocus.org 25


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