Agencies Release Regulatory Review Plans

WASHINGTON — Yesterday the Office of Management and Budget
released preliminary regulatory review plans from 30
federal agencies noting regulations on the books that will either
be modified or ditched altogether.

In a Jan. 18 executive order, President Obama called for a
government-wide review of existing rules to identify those that
need to be changed or removed because they are outdated,
unnecessary, excessively burdensome or in conflict with other
rules.

“I am directing federal agencies to do more to account for
— and reduce — the burdens regulations may place on
small businesses,” Obama explained in an opinion piece in the The Wall Street
Journal. “Small firms drive growth and create most new jobs in
this country. We need to make sure nothing stands in their
way.”

The agencies were given 120 days to come up with plans for a
periodic review of existing regulations. The plans were due May
18.

In accordance with the review, regulations must be
cost-justified and coordinated, transparent and science-driven.
Federal agencies must also consider regulatory approaches that
“maintain flexibility and freedom of choice for the public,”
including disclosure of information.

As part of the review plan submitted by the Department of Health
and Human Services, CMS said it has begun a Medicare and Medicaid
alignment initiative to identify conflicting requirements between
the two programs for dual eligibles. The agency highlighted a
number of other review initiatives and said it has approximately 80
additional reform proposals under development. It plans to present
those proposals to HHS leadership throughout the summer.

Among requests from commenters, CMS said it was asked to look
at:

• Streamlining of claims review by multiple contractors including
  Medicare Parts A and B Recovery Audit Contractors, Medicare
  Administrative Contractors, Medicaid Integrity Contractors,
  Comprehensive Error Rate Testing Contractors, and Zone Program
  Integrity Contractors, which were presented as often redundant;

• Medicare documentation requirements;

• Improvements to the Medicare enrollment process; and

• Improved education and outreach to physicians about new
  requirements.

Following Obama’s order, the American Association for Homecare
requested a review of “onerous
and outdated regulations that hamper job creation and threaten
access to quality home medical equipment and services under the
Medicare program.” The association specifically asked for an
examination of rules related to competitive bidding, respiratory
therapy, power mobility devices, diabetes testing equipment, audits
and anti-fraud and abuse initiatives.

The Center for Regulatory Effectiveness also wrote HHS to
request a review
of CMS’ competitive bidding regulations “because they are
poorly designed, contradicting the president’s regulatory goals by
needlessly sacrificing thousands of small businesses and tens of
thousands of jobs.”

Kansas Republican Sen. Pat Roberts sent a letter to President
Obama as well listing competitive bidding among regulations
that pose a negative economic impact. “We originally had over
400 DME providers in Kansas; however, now that Round 1 has been
implemented I am concerned that patients, especially in rural
areas, are facing issues related to access,” Roberts wrote.

The regulatory review plans from the federal agencies, including
plans from HHS, are available on the White House website at
http://www.whitehouse.gov/21stcenturygov/actions/21st-century-regulatory-system.