A final rule revising Medicare’s conditions of participation for hospitals could impact physicians’ role in hospital governance and patient care activities. The Centers for Medicare & Medicaid Services (CMS) needs to give the rule more thought and institute an immediate delay before implementation, the AMA and more than 80 other medical associations told the agency in a letter Tuesday.
Under the latest final rule, published in May and scheduled to take effect July 11, a multi-hospital health system would be permitted to have a single, integrated medical staff. CMS took a middle ground approach by requiring that when a hospital elects to have a single medical staff, each individual hospital medical staff must opt in or opt out.
The final rule also replaces a requirement for the hospital governing body to include a member of the medical staff with a requirement that the governing body must directly consult at least two times per year with the medical staff.
The AMA and other medical societies are calling on CMS to delay the rule’s effective date until May 12, 2015, a year after the rule was published.
“We think this is an ill-conceived policy that will disenfranchise physicians and hinder their input into hospital programs, especially for those physicians in rural or geographically distant hospitals,” the letter said. “We have also expressed serious concerns about the negative effects that this structure may have on patient care as well as the negative repercussions for system-wide care coordination activities.”
The organizations argued that medical staffs need more time to prepare and that CMS must provide guidance on a number of issues before the rule can be implemented. The letter reiterated the importance of delaying the rule after CMS responded to earlier correspondence and conveyed it didn’t plan to delay the effective date.
The letter also asks the agency to further consider several issues that are unclear in the latest version of the final rule, including licensure requirements and peer review protections.
“This rule makes unprecedented changes to the Medicare hospital conditions of participation that will dramatically alter the make-up and efficacy of hospital medical staffs nationwide,” the letter said.
In addition to the AMA’s advocacy work with CMS, the AMA Organized Medical Staff Section is working on resources to help medical staffs inform their membership about how to best influence the path forward, such as whether to join a system-wide medical staff, and structure consultations with the governing body.
