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Regulatory Relief

FAH member hospitals are committed to ensuring patients receive high-quality care and believe a comprehensive review and repeal or revision of regulations that are outdated, ineffective, or otherwise overly burdensome will improve health outcomes and efficiencies in care delivery. The FAH recommends that the Department of Health and Human Services (HHS), including the Centers for Medicare & Medicaid Services (CMS), examine policies through the lens of benefit to beneficiaries balanced against the time, effort, and resources required by providers to determine whether the policies will result in meaningful improvements in quality, efficiency, or beneficiary experience.   

The FAH has submitted recommendations to HHS and CMS regarding actions the agencies could take to implement regulatory reform across a variety of areas, such as alternative payment models, Medicaid, hospital and post-acute payment policies, and quality measurement and reporting. Some of the recommendations include:

  • Ensuring that the Center for Medicare & Medicaid Innovation (CMMI) act only within its designated authority to voluntarily test innovative payment and care delivery models, not make permanent or mandatory changes to the Medicare program. CMS has successfully demonstrated that it is fully capable of testing models under section 1115A solely through providers of services and suppliers that volunteer to participate in those models (e.g., the Bundled Payments for Care Improvement (BPCI) Initiative). Encouraging voluntary participation by providers and suppliers was the intent of Congress in enacting section 1115A and is the proper and appropriate use of legislatively granted demonstration authority.
  • Indefinitely suspending the troubled Hospital Star Ratings system for as long as needed while CMS collaborates with stakeholders and quality experts to ensure that any future system includes appropriate risk adjustment and accurately distinguishes among providers. The currently flawed Ratings system does not provide accurate information on which beneficiaries, their families, and their providers can rely to make decisions about their care.
  • Ensuring that CMS provide hospitals with broad flexibility to relocate their provider-based departments to meet community needs and still retain Outpatient Prospective Payment System (OPPS)-based hospital payments under section 603 of the Bipartisan Budget Act of 2015. At minimum, a number of exceptions, such as lease expiration and organic growth and community needs, are necessary for hospitals to deliver efficient, high quality care in a safe location. This flexibility would enable hospitals to successfully renegotiate favorable lease terms, comply with local building codes, and preserve access to care in the aftermath of a natural disaster. CMS regulations, however, unreasonably restrict a hospital’s ability to do so by stipulating that under most circumstances an existing provider-based department that relocates would forfeit its ability to be paid as a hospital outpatient department.