On September 26, the Centers for Medicare and Medicaid Services (CMS) issued a final rule to remove or update Medicare regulations the agency has identified as unnecessary, obsolete, or excessively burdensome on hospitals and other healthcare providers. This includes regulatory updates for Critical Access Hospitals (CAHs), rural health clinics (RHCs) federally qualified health centers (FQHCs), and hospital and CAH swing-bed providers. Among other updates for CAHs, the final rule replaces the current requirement on systems for infection control with a new infection prevention and control and antibiotic stewardship Condition of Participation (CoP). CMS is also requiring that CAHs develop, implement, and maintain Quality Assessment and Performance Improvement Programs (QAPI) programs, that will replace the existing annual evaluation and quality assurance review requirement. In implementing the QAPI requirements, CMS encourages CAHs to utilize the technical assistance and services available through the State Flex Programs, including the Medicare Beneficiary Quality Improvement Project (MBQIP). For RHCs and FQHCs, the final rule reduces the frequency of review of the patient care policies and facility evaluation from annually to every two years. The final rule also makes changes to other requirements such as those pertaining to emergency preparedness. To see all the facility types and regulations affected, you may access the final rule in the Federal Register. These regulations will go into effect on November 29, 2019, except for the CAH QAPI and antibiotic stewardship requirements (March 30, 2021 and March 30, 2020, respectively).
