CMS Issues New RFI for Patients over Paperwork Initiative

June 6, 2019

The Centers for Medicare & Medicaid Services (CMS) has issued a request for information (RFI) on how to evolve its “Patients over Paperwork” initiative that was initially launched in 2017.

Since launching in fall 2017, according to agency officials, the Patients over Paperwork program “has streamlined regulations to significantly cut the ‘red tape’ that weighs down our healthcare system and takes clinicians away from their primary mission—caring for patients. As of January 2019, CMS estimates that through regulatory reform alone, the healthcare system will save an estimated 40 million hours and $5.7 billion through 2021. These estimated savings come from both final and proposed rules.”

The federal agency said it has gathered feedback on burdensome requirements from medical and patient communities through other RFIs, listening sessions, and on-site meetings with frontline clinicians, healthcare staff, and patients. To date, officials said that CMS has addressed or is in the process of addressing 83 percent of the actionable areas of burden identified through the 2017 RFI.

For instance, modernizing documentation requirements and billing codes has been a major priority for CMS. Practical examples of changes CMS has already made include allowing initial prescriptions of immunosuppressive drugs to be shipped to an alternate address other than the beneficiary’s home to help ensure timely access to these drugs when the beneficiary does not return home immediately after discharge. And, CMS has confirmed regulatory changes to home health recertification and eliminated the need for a physician to include a separate statement about how much longer home health services are needed. “These common-sense measures add up to save time and cut down on paperwork throughout a clinician’s day,” CMS officials noted.

Another example is the agency’s “Meaningful Measures” initiative, which is aligned with Patients over Paperwork and was also launched in 2017. Here, CMS has worked closely with healthcare stakeholders to identify and pursue high-priority areas for quality measurement and improvement to achieve better outcomes while reducing clinician burden.

Through policies advancing Meaningful Measures, CMS said it has eliminated 79 overly burdensome, redundant, or low-value measures for a projected savings of $128 million and anticipated reduction of 3.3 million burden hours through 2020. Additionally, the agency has looked to reduce the burden of reporting measures by enabling their electronic submission and incentivizing use of clinical registries.

Now, the new RFI provides an opportunity to share original ideas not conveyed during the first Patients over Paperwork RFI in 2017 and continue the national conversation on improving healthcare delivery, according to agency officials. CMS is especially seeking innovative ideas that broaden perspectives on potential solutions to relieve burden and ways to improve:

             Reporting and documentation requirements

             Coding and documentation requirements for Medicare or Medicaid payment 

             Prior authorization procedures

             Policies and requirements for rural providers, clinicians, and beneficiaries

             Policies and requirements for dually enrolled (i.e., Medicare and Medicaid) beneficiaries

             Beneficiary enrollment and eligibility determination

             CMS processes for issuing regulations and policies

“We are doubling down on efforts to decrease healthcare costs by reducing administrative burden. In removing what doesn’t add value, we’re making room for what does. Our goal is to ensure that doctors are spending more time with their patients and less time in administrative tasks,” CMS Administrator Seema Verma said in a statement today. “Since launching Patients over Paperwork in late 2017, CMS has worked closely with the healthcare community to relieve regulatory burden and maintain flexibility and efficiency in Medicare and Medicaid, and we’re excited about the innovative ideas that today’s RFI will bring as we build on our progress and continue to achieve cost and time savings.”

Comments to CMS on the RFI must be submitted by August 12, 2019.

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