U.S. Moves to Cut Back Regulations on Hospitals
Wednesday, October 19, 2011
U.S. Moves to Cut Back Regulations on
Hospitals
By : Robert Pear, New York Times
WASHINGTON - The Obama administration moved Tuesday to roll back
numerous rules that apply to hospitals and other health care
providers after concluding that the standards were obsolete or
overly burdensome to the industry.
Kathleen Sebelius, the secretary of health and human services,
said the proposed changes, which would
apply to more than 6,000 hospitals, would save providers nearly
$1.1 billion a year without creating any "consequential risks for
patients."
Under the proposals, issued with a view to "impending physician
shortages," it would be easier for hospitals to use "advanced
practice nurse practitioners and physician assistants in lieu of
higher-paid physicians." This change alone "could provide immediate
savings to hospitals," the administration said.
Other proposals would roll back rules for doctors' offices,
kidney dialysis centers, organ transplant programs, outpatient
surgery centers and institutions for people with severe mental
disabilities.
In January, President Obama ordered his appointees to modify or
revoke rules that were outmoded, ineffective or "excessively
burdensome." Republicans in Congress have demanded such changes,
arguing that many federal rules have stifled economic growth and
job creation.
Many of the new proposals deal with Medicare and Medicaid rules
that have not been altered in decades. In general, the proposals do
not affect the large number of rules issued under the new health
care law, which set detailed standards for coverage offered by
insurance companies and employers.
One of the new proposals would allow hospital patients to take
certain drugs on their own, with the approval of hospital officials
but without immediate supervision by a nurse. A hospital may allow
a patient to "self-administer both hospital-issued medications and
the patient's own medications brought into the hospital," the
proposal says. In the past, hospitals have often restricted
patients' ability to give medications to themselves.
Another proposal would relax requirements for hospitals to
notify the federal government immediately after the death of any
patient who had been confined with certain wrist restraints like
those used to prevent patients from harming themselves by pulling
out intravenous tubes.
Other proposals would eliminate requirements for hospitals to
keep detailed logs of infection control problems and would relieve
certain organ transplant centers of the need to certify the blood
type of organ donors. Hospitals would still have to investigate
outbreaks of infections, and other medical experts would check on
donors' blood type.
The administration said it was proposing the second change "in
an effort to reduce the administrative burden for transplant
centers and the surgeons" who obtain organs for transplants.
The administration also proposed eliminating fire safety
standards for certain kidney dialysis centers. The federal
standards duplicate state and local standards and would require
some dialysis centers to make costly structural changes, it
said.
Federal officials would also eliminate a detailed list of
emergency equipment that must be available in the operating rooms
of outpatient surgery centers. Such clinics would have leeway to
decide what equipment was needed for the procedures they
performed.
Under current rules, each hospital must have its own governing
body, which is legally responsible for its operations. Under the
proposal, a multihospital system could have a single governing body
for all its hospitals.
The administration will accept public comments on the proposals
for 60 days and will review the comments before issuing final rules
with the force of law.
Not all the rules are aimed at saving money. One proposal would
discontinue use of the term "Medicaid recipients" to refer to
low-income people receiving medical assistance. In the future, the
government will refer to them as Medicaid beneficiaries, just as it
speaks of Medicare beneficiaries.