The Centers for Medicare & Medicaid Services today issued a final rule reforming Medicare regulations identified as unnecessary or excessively burdensome on hospitals and other health care providers, which the agency expects to save providers about $660 million a year. As strongly advocated by AHA, the rule revises a CMS proposal that each hospital have its own medical staff, even in multi-hospital systems. CMS has reinterpreted current regulations to allow for a unified and integrated medical staff shared by multiple separately certified hospitals within a hospital system. CMS also rescinds a regulation requiring hospital governing boards to include a member of the medical staff, and replaces it with a requirement to periodically consult with the individual assigned the responsibility for the organization and conduct of the hospital’s medical staff, or his or her designee. According to a CMS press release, the rule also reduces the burden on small critical access hospitals, rural health clinics and federally qualified health centers by eliminating the requirement that a physician be held to a prescriptive on-site schedule. Among other provisions, the agency said the rule permits registered dietitians and qualified nutritionists to order patient diets directly, without requiring the preapproval of a physician or other practitioner. The final rule will be published in the May 12 Federal Register, with most provisions effective 60 days after publication. AHA staff are reviewing the rule and will provide more information to members soon.