Wednesday, May 23, 2012
This Week's News
This Week's News
Medical staff, patient safety protected in final Medicare hospital rule
Numerous provisions that would have diluted the authority of hospital medical staffs and threatened patient safety have been eliminated from the Centers for Medicare & Medicaid Services' (CMS) revised Medicare conditions of participation for hospitals, thanks to efforts by the AMA and more than 80 other medical associations.
CMS published a final rule on the hospital conditions of participation May 10 in response to formal comments submitted by the AMA and the other medical associations. Changes to CMS's initial proposal will prevent detrimental ramifications for physicians and their patients.
Under the initial proposal, multi-hospital systems would have been allowed to limit physician representation to a single medical staff across their hospitals, regardless of distinct locations, specialties or patient populations. CMS removed this provision from the final rule after the medical associations pointed to the importance of individual medical staffs that understand the unique safety and health needs of their patients.
Another proposed revision would have subjected credentialing for medical staff membership to a hospital's policies and procedures, giving the hospital undue authority over the medical staff. The final rule clarifies that physicians should be credentialed based on the medical staff bylaws, rules and regulations.
CMS also removed a proposed provision that would have allowed hospitals to privilege physicians without appointment to the medical staff. Physicians excluded from the medical staff would have been denied a voice in self-governance and potentially refused the right of peer review, which would have undermined the authority of the medical staff in the hospital.
In addition, the hospitals participating in Medicare are now required to include at least one member of the medical staff on their governing bodies. This requirement is intended to promote greater coordination between the medical staff and non-physician leadership while informing patient health and safety initiatives within a hospital.
Several troubling revisions, including the option for multi-hospital systems to have a single governing body, remain in the final rule. The AMA is working with CMS to address these issues.