Thursday, September 26, 2019

Very Brief Blog: CMS Finalizes Its Delayed Antibiotic Stewardship Requirements for Hospitals

Take Home Message:

On September 25, 2019, CMS released final rulemaking requirement for hospitals to have active Antibiotic Stewardship Programs by mid 2020.   

See the rulemaking here and the regulation itself here.  

Coverage in Modern Healthcare here.


Over the past 5 years, there has been increasing emphasis on the need for national action against antibiotic resistance as a public health threat.   In 2016, CMS proposed hospital regulations that would require all hospitals to have Antibiotic Stewardship Programs, just as they must have infection control programs. 

The regulation seemed to stall in 2017/2018, and the proposal would have expired entirely in June 2019.   In April 2019, the President's Advisory Council on antibiotic issues voted unanimously that CMS should finalize the requirement (here).  Many other stakeholders supported this (e.g. here and here.)    This led CMS to recently extend the sunset date on the proposed regulation from June 2019 to June 2020.

On September 25, 2019, CMS released final rulemaking requirement that hospitals shall have active Antibiotic Stewardship programs by mid 2020.   Primarily, the regulation requires hospitals to meet one of several available national standards, such as CDC Core Requirements for ASP's.   See the rulemaking here and the regulation itself here.


See a link collection of some policy & press about ASP here.


Gender Rule Nixed

The original June-2016-era proposal had many sections, including regulations that would define sex discrimination to include gender identity.   The current administration defines sex discrimination to exclude gender identity (e.g. there will be Supreme Court cases on this in the upcoming 2020 term).   The finalized rule simply states that some supported the definition and some opposed and the definition is not finalized (that is, the new gender text is absent from the final regulations). 


And Autopsy Regulation is Deep-Sixed

As proposed in June 2019, the new conditions of participation delete prior requirements for hospital autopsy programs, on the principal that they are redundant to state laws.


Transplants Simplified

In the CMS press release, administrative simplifications and burden reductions are emphasized.  This includes simplifying transplant rules.