CMS Seeks Comments on Patients over Paperwork Initiative

June 14, 2019
Policy Snapshot

The Centers for Medicare & Medicaid Services (CMS) created the Patients over Paperwork initiative to eliminate outdated, duplicative, and overly burdensome regulations so clinicians and providers can focus on their primary mission: patient care. Savings to providers and clinicians are estimated at $5.7 billion and 40 million burden hours through 2021. Estimated savings come from both final and proposed rules. This includes the elimination of 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. 

Over the last two years, CMS solicited feedback from the medical and patient communities through Requests for Information (RFIs), listening sessions, and on-site engagements with front-line clinicians, staff, and patients. CMS addressed or is in the process of addressing 83% of the actionable areas of burden identified through the 2017 Request for Information (RFI). Using the information gained, CMS made changes such as:

  • Allowing patient notes written by medical students to count for billing purposes when the supervising clinician signs off
  • Streamlining the process that Medicare beneficiaries, providers, and suppliers must follow to appeal denials
  • Making 11 updates to modernize and reduce burden related to Local Coverage Determinations
  • Changing 13 documentation requirements

Last week, CMS issued an RFI inviting patients and their families, the medical community, and other health care stakeholders to recommend further changes. This RFI provides an opportunity for stakeholders to share new ideas not conveyed during the first Patients over Paperwork RFI in 2017. CMS is seeking innovative ideas to relieve burden and ways 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 (i.e., Medicare and Medicaid) beneficiaries
  • Beneficiary enrollment and eligibility determination
  • CMS processes for issuing regulations and policies

Comments can be submitted here by August 12. CMS also continues listening to you via this Patients over Paperwork email address: