CMS 提出 CARE 拟议规则精简医疗机构监管：预计节省3.2亿美元
美国联邦医疗保险与医疗补助服务中心（CMS）11月5日发布「为卓越患者护理削减行政要求」（CARE）拟议规则（CMS-3484-P），拟修订适用于参加联邦医疗保险与医疗补助计划的医疗服务提供者与供应商的参与条件等监管要求，以降低成本、提高透明度并精简现有规制；同时拟取消部分医疗补助机构支付透明度报告要求，减轻各州与机构提供者的负担。
CMS 对全部21类提供者与供应商的参与条件作了全面审查，找出过时与负担过重的规制。CMS 估计，全部拟议修改合计可节省3.2亿美元，并为医疗机构员工返还超过326万小时的时间。具体包括：医院与危重症医院（CAH）拟取消转诊流程与急诊服务准备的人员培训要求、以及产科护理的专门质量评估要求，同时新设关于分娩组织采集的患者权利要求（知情同意与尊重家庭文化、宗教或个人意愿的流程）；长期护理机构拟取消为员工讲解、提供新冠疫苗并作记录的要求、精简住客相关要求，并取消持续呼吸道疾病数据报告（公共卫生紧急状态期间的专项报告保留）。
规则还拟采用2024年版国家消防协会生命安全与医疗设施规范及2022年版应急与备用电源系统规范，取消病房区须有外窗或外门采光通风的要求，并撤销三项医疗补助机构支付透明度报告（护理机构直接护理人员薪酬占比、支持人员薪酬占比等）。CMS 同时就六个议题征求意见，包括长期护理住客退出出院通知抄送监察员、麻醉师护士的医生监督灵活性、扩大医师助理与执业护士在长期护理机构的执业范围、移植项目初始认证门槛与医疗补助机构人力短缺等。
（来源：美国联邦医疗保险与医疗补助服务中心）
CMS Proposes CARE Rule to Streamline Provider Regulations, Saving an Estimated $320 Million
The Centers for Medicare & Medicaid Services (CMS) on November 5 issued the Cutting Administrative Requirements for Excellence in Patient Care (CARE) proposed rule (CMS-3484-P), proposing revisions to the Conditions of Participation, Conditions for Coverage and Requirements for Participation for Medicare- and Medicaid-participating providers and suppliers. The revisions would reduce costs, increase transparency, enhance flexibility for providers to deliver innovative patient care, and streamline existing regulations; the rule also proposes to rescind certain Medicaid institutional payment transparency reporting requirements.
CMS conducted a comprehensive review of the requirements for all 21 provider and supplier types and estimates the proposals would collectively save $320 million, returning more than 3.26 million hours of staff time to providers. For hospitals and critical access hospitals, CMS proposes removing staff training requirements for transfer protocols and emergency services readiness and the obstetric-care-specific quality assessment requirements, while establishing new patients' rights requirements on birth tissue collection, including informed consent and processes for families requesting their birth tissues for cultural, religious, or personal reasons. For long-term care facilities, it proposes removing COVID-19 vaccine education, offering and documentation requirements for staff, streamlining the remaining resident requirements, and removing continuing respiratory illness data reporting while retaining reporting during a future declared public health emergency.
The rule would also adopt the 2024 editions of the National Fire Protection Association Life Safety and Health Care Facilities Codes and the 2022 Emergency and Standby Power Systems Codes, remove the requirement that patient care areas have exterior windows or doors for natural light and ventilation, and rescind Medicaid institutional payment transparency reporting on the shares of payments spent on direct care worker and support staff compensation. CMS is also soliciting comments on six topics, including discharge-notice opt-outs for long-term care residents, physician supervision flexibility for certified registered nurse anesthetists, expanding physician assistant and nurse practitioner practice in long-term care facilities, transplant program certification criteria, and Medicaid institutional workforce shortages.
(Source: Centers for Medicare & Medicaid Services)
来源：美国联邦医疗保险与医疗补助服务中心
发布：GSM·美国（发布链接）
图片来源：图：位于华盛顿的美国卫生与公众服务部休伯特·汉弗莱大楼外景（CMS 为其下属机构）。ajay_suresh 摄，CC BY 2.0，经 Wikimedia Commons。 / Photo: The Hubert H. Humphrey Building of the U.S. Department of Health and Human Services in Washington; CMS is an agency within HHS. Photo by ajay_suresh, CC BY 2.0, via Wikimedia Commons.
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