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Medicare's Requirement for Antimicrobial Stewardship Programs Gets Delayed

Cheryl Thompson

Cheryl ThompsonDirector
News Center

The federal proposal to require antimicrobial stewardship programs in all acute care and critical access hospitals participating in the Medicare and Medicaid programs seems to be among the items awaiting arrival of a new administrator at the overseeing agency.

Publication of the final rule on that condition of participation and others had been scheduled for November 10, according to a slide deck prepared by the Centers for Medicare and Medicaid Services (CMS) for a presentation last August.

But the results from the November 8 election put the brakes on finalization of the rule, said Jillanne M. Schulte, Director of Federal Regulatory Affairs for ASHP.

“Generally speaking, when there’s a transition of administrations, there is a grace period,” Schulte said. “It’s not required, but it’s sort of a courtesy period where agencies do not finalize new rules until the new administration takes office.”

A notation in the Department of Health and Human Services (HHS) semiannual regulatory agenda, issued on the Friday before Christmas 2016, states “06/00/19” as the date for final action on the proposed rule that would add antimicrobial stewardship programs to the conditions of participation for acute care and critical access hospitals.

According to a press officer with CMS, the date June 2019 reflects the legal deadline of three years for any HHS agency to finalize a rule, not the agency’s expected date for finalizing the rule in question.

“This is a fairly large rule; there are costs attached to it,” Schulte said. “So there’s a chance that the new administrator will want to review it before it becomes public.”

The Trump–Pence Transition Team announced on December 7 that Seema Verma is the nominee for administrator of CMS and Rep. Tom Price is the nominee for secretary of HHS.

Verma is the president, CEO, and founder of a national health policy consulting company. Price, from Georgia, has nearly 20 years’ experience as an orthopedic surgeon in private practice.

The dates of confirmation hearings for Verma and Price have not yet been announced.

Schulte said she has not seen any indication of CMS retreating from its stance on the need for hospitals to have antimicrobial stewardship programs.

“It’s a very important public health priority,” she said, “and I don’t think that this is something that they’re just going to drop.”

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