Regulatory Update: June 2016

June 2016

Proposed Rule: Advanced Practice Registered Nurses

On May 25, 2016, the Department of Veterans Affairs (VA) published a proposed rule that aims to expand the scope of practice of advanced practice registered nurses (APRN) - certified nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists and certified nurse-midwives - who work for the agency in order to provide veterans with greater and timely access to care. The VA contends that full practice authority will help optimize access to VA health care by permitting APRNs to assess, diagnose, prescribe medications and interpret diagnostic tests. This propose rule would also help to expand the pool of qualified health care professionals authorized to provide primary health care and other related health care services to the full extent of their education, training and certification to Veterans without the clinical supervision of a physician.

Medicare Shared Savings Program; Accountable Care Organizations-Revised Benchmark Rebasing Methodology, Facilitating Transition to Performance-Based Risk, and Administrative Finality of Financial Calculations

On June 6, 2016, the Centers for Medicare & Medicaid Services (CMS) published a final rule revising the Medicare Shared Savings Program (MSSP), in which providers and suppliers that participate in an Accountable Care Organization (ACO) may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. The final rule changes the savings calculation formula by phasing in regional fee-for-service expenditures into the methodology for establishing, adjusting and updating the benchmarks for ACOs that continue participating in MSSP after an initial three-year agreement period; adds a participation option to encourage ACOs to transition to performance-based risk arrangements; and provides greater administrative finality around the program’s financial calculations. 

Proposed Rule: Hospital and Critical Access Hospital Changes to Promote Innovation, Flexibility, and Improvement in Patient Care

On June 13, 2016, CMS displayed a proposed rule to make changes to the Medicare and Medicaid Conditions of Participation (COPs) for all hospitals and CAHs. The current hospital COPs are codified in regulation at 42 CFR Part 482 while the CAH COPs are at 42 CFR Part 485, Subpart F. The COPs are further interpreted by CMS in the State Operations Manual which provide guidance to hospital surveyors on the COPs and tells hospitals and CAHs what to expect at their surveys.