Uncertainty Looms Amid Federal Healthcare Oversight Upheaval

Since Jan. 20, it seems that uncertainty in healthcare has become the new normal. After a contentious hearing, Robert F. Kennedy, Jr. was appointed to head the U.S. Department of Health and Human Services (HHS). Dr. Mehmet Oz will be testifying before Congress on March 14 as he aims to be appointed head of the Centers for Medicare & Medicaid Services (CMS). Dr. Jay Bhattacharya has testified to head the National Institutes of Health (NIH), and Dr. Marty Makary to head the Food and Drug Administration (FDA), with their appointments all but assured.

But what remains unclear is the direction that the new administration will take with developing healthcare policy. As you may have read in RACmonitor articles, Kennedy declared that the agency would no longer utilize notice-and-comment rulemaking procedures (read here and here.)

Throughout all this uncertainty, hospitals, surgery centers, nursing homes, physician offices, and all other providers must continue to provide quality medical care to patients.

And as these dramatic changes all take shape, last week CMS sent out notices that the planned Open Door Forums for Hospital, Physician, Skilled Nursing Facility, and Ambulance providers were cancelled, with no indication that they would be rescheduled. The CMS Open Door Forum registration page, which previously listed a multitude of events, now only lists one End Stage Renal Disease Open Door Forum, scheduled for March 18.

The willingness of CMS to listen and interact with providers of all types throughout the years has always been much appreciated. Anyone who has read a proposed rule and submitted a comment knows that CMS does in fact read every comment and addresses them in the final rule commentary. They are keenly aware that while they are experts in the laws and regulations, as administrators, they cannot anticipate all the real-world implications of their proposals, and truly count on providers to read the proposals and guide their modifications. Many a comment has led to a significant change in a proposed rule.

Likewise, the Open Door Forums, especially in the first few months of the year, allow providers to once again provide CMS feedback and ask questions about the annual rule updates, now that providers have operationalized them. Anyone who worked through the COVID-19 Public Health Emergency (PHE) and frequent regulatory waivers knows the value of these calls.

On the glass-half-full side of these changes at CMS, as hospitals have rolled out the new appeal process for certain hospital patients with a status change and delivery of the Medicare Change of Status Notice, CMS has continued to respond quickly and thoughtfully to questions, helping to address the many nuances that came to light when Feb. 14, the implementation date, rolled around.

We all know change is inevitable; I am sure all of you agree with me that the role that CMS career staff play in our daily work lives is crucial, and we are all grateful for their past openness and accessibility.

We can only hope that continues as the new HHS structure and policies continue to take shape.

Programming note: Listen live every Monday morning when Dr. Ronald Hirsch makes his Monday Rounds on Monitor Mondays with Chuck Buck and sponsored by R-1 Physician Advisory Services