AHA urges CMS to clarify interpretive guidelines

The American Hospital Association Friday urged the Centers for Medicare & Medicaid Services to clarify language in a recent letter to state survey directors that appears to limit the use of standing orders and protocols. The letter contained interpretive guidelines for regulatory changes to the hospital conditions of participation in Medicare, including language implying that all protocols and standing orders require a physician’s order prior to initiation for each patient. In a letter to CMS, the AHA said the language “likely will lead to patient harm, is counter to accepted standards of care and will impede hospitals’ progress on quality improvement initiatives.” The AHA urged CMS to immediately clarify the interpretive guidelines to reflect the intent of the CoP, which is to require that standing orders and medical staff orders for drugs and biologicals be written in the patient’s chart and later signed by a practitioner responsible for the care of the patient.