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CMS seeks input on Patients over Paperwork initiative to reduce red tape and to lower costs

Regulatory reform is estimated to save the healthcare system an estimated 40 million hours and $5.7 billion from 2019 through 2021.

Susan Morse, Senior Editor

The Centers for Medicare and Medicaid Services is seeking public input on how to continue progress in the Patients over Paperwork initiative to reduce administrative burden and lower costs.

CMS has issued a Request for Information for patients, their families, the medical community and other healthcare stakeholders to recommend further changes to rules, policies, and procedures that would shift more of clinicians' time from paperwork to care. Comments must be submitted by August 12.

CMS is especially seeking ideas 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 in Medicare and Medicaid
  • Beneficiary enrollment and eligibility determination
  • CMS processes for issuing regulations and policies


Reducing unnecessary paperwork also cuts costs and time.

Regulatory reform is estimated to save the healthcare system an estimated 40 million hours and $5.7 billion from 2019 through 2021. These estimated savings come from both final and proposed rules, CMS said.


Patients over Paperwork launched in the fall of 2017.

To date, CMS has addressed or is in the process of addressing 83 percent of the actionable areas of burden. It has received input from over 2,000 stakeholders across 23 states through interviews, listening sessions and on-site visits to healthcare facilities, practices, and beneficiaries' homes.

CMS burden reductions include allowing initial prescriptions of immunosuppressive drugs to be shipped to an alternate address other than the beneficiary's home to ensure timely access to these drugs when the beneficiary does not return home immediately after discharge.

Also, there have been regulatory changes to home health recertification that have eliminated the need for a physician to include a separate statement about how much longer home health services are needed.

Beginning in October, the Patient Driven Payment Model, a new case-mix classification system that applies to skilled nursing facilities, will tie SNF payments to patients' conditions and care needs rather than the quantity of services provided. This will simplify the current paperwork requirements for patient assessments, saving an estimated $2 billion over 10 years.

CMS has developed a five-part plan for nursing home care.

The CMS patient-centered Meaningful Measures initiative, also launched in 2017, aligns with Patients over Paperwork. Through policies advancing Meaningful Measures, CMS 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, CMS said.

Additionally, the agency has reduced the burden of reporting measures by enabling their electronic submission and the use of clinical registries.


"Patients over Paperwork remains a top priority and a driving force in lowering healthcare costs," said CMS Administrator Seema Verma. "In step with the Trump Administration's Cut the Red Tape initiative to reduce overly burdensome regulations across the federal government, Patients over Paperwork has made great inroads in clearing away needlessly complex, outdated, or duplicative requirements that drain clinicians' time but contribute little to quality of care or patient health.

Twitter: @SusanJMorse
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