The Centers for Medicare & Medicaid Services today released a proposed rule aimed at reducing burden and promoting efficiency for hospitals, critical access hospitals and other providers. In addition to changes and clarifications to selected requirements for providers, the rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation. Specifically, the rule would rescind a recently adopted hospital regulation requiring that a hospital's governing board include a member of the medical staff. CMS instead proposes to require that a hospital's governing body periodically consult with a designated member of the medical staff. For multi-hospital systems with a single governing body, the governing body would need to consult with a member of the medical staff from each hospital in the system. The proposed rule also contains regulatory changes stipulating that each hospital, including those within a multi-hospital system, must have its own medical staff. "Today's proposed rule is an important step forward in further reducing burdensome requirements to hospitals," said AHA President and CEO Rich Umbdenstock, adding that the changes will be particularly welcomed by small and rural hospitals. "We especially applaud CMS for proposing to rescind the regulation that hospital governing boards must include a member of the medical staff. While most hospitals have physicians on their governing boards, CMS recognized that the requirement was not feasible for all hospitals. CMS revamped the requirements to focus on the need for good communication between governing boards and medical staff members about patient care. However, we are disappointed that CMS did not allow hospitals in multi-hospital systems to have single integrated medical staff structures if that's how those providers choose to be organized. Hospitals are delivering more coordinated, patient-centered care and CMS should not let antiquated organizational structures stand in the way."