Eleven Minutes Per Birth Is $691 Million
CMS filed its long-pending deregulation rule at 4:15 this afternoon, 378 pages that strip Conditions of Participation across 21 provider types and claim $320 million a year in savings. One new requirement goes in at the same CFR citation the rule empties out, and by CMS's own tables it costs hospitals and critical access hospitals $873.0 million over ten years, more than a fifth of everything the rule gives back.
Section 482.59(c) of the Medicare hospital Conditions of Participation says today that a hospital offering obstetrical services has to train its staff on obstetrical care.
A proposed rule CMS put on the Federal Register's public inspection desk at 4:15 p.m. Eastern this afternoon deletes that paragraph and writes a different requirement into the same address.
The rule is CMS-3484-P, "Cutting Administrative Requirements for Excellence in Patient Care," RIN 0938-AW04. It ran 378 pages, it publishes November 10, and it had zero page views when we pulled it. CMS says it reviewed the Conditions of Participation for all 21 provider and supplier types, read the 937 timely submissions to last year's deregulatory RFI, and arrived at an average annual savings of approximately $320 million.
Every one of those dollars is in the executive summary's cost table. The one new requirement does not have a line in it.
"What does the cutting rule cost the people it is cutting for?"
Where the $320 Million Actually Is
The section-by-section totals read like this: long term care facilities $142.6 million a year, hospitals $123.2 million, critical access hospitals $16.6 million, ICFs/IID $6.6 million, and providers filing Medicaid institutional payment transparency reports another $30.4 million. Rural emergency hospitals get nothing either way. The only stated cost in the summary is $112,000 a year for the Life Safety Code update.
Nursing homes beat hospitals, and it is not close once you open the tables.
Two repeals carry almost all of it.
Killing the weekly non-PHE acute respiratory illness report at § 483.80(g) is $62.64 million a year and $626,385,783 over ten, spread across the 14,732 LTC facilities CMS counted in February. Dropping the staff COVID-19 vaccine educate, offer and document requirement is another $60,608,613 a year, $606,086,130 over ten.
Those two lines are $1.23 billion of the $1.426 billion LTC total. Everything else in the nursing home section, the facility assessment change, the CHOW exemption from room occupancy standards, the Ombudsman transfer notice, adds up to the remaining 14%.
The rest of this brief is for subscribers.
The impact tables, the code-level detail, and the rest of the analysis sit past this line.
$50 a month, or $500 a year.
Already a subscriber? Sign in