CMS PROPOSED RULE: CONDITIONS OF PARTICIPATE; REGULATORY CHANGES
Medicare and Medicaid Programs: Reform of Hospital and Critical
Access Hospital Conditions of Participation; and Regulatory Provisions
May 2012 to Promote Program Efficiency, Transparency, and Burden Reduction
On May 10, 2012 the Centers for Medicare and Medicaid Services (CMS) published two final rules (CMS-3244-F
and CMS-9070-F) aimed at reducing procedural burdens on providers by identifying existing regulations that,
according to the agency, “can be eliminated as obsolete, unnecessary, burdensome, or counterproductive or
that can be modified to be more effective, efficient, flexible, and streamlined.” CMS estimates that the reforms
designated in the two rules will save nearly $1.1 billion across the healthcare system within a year and over $5
billion over five years.
Reform of Hospital and Critical Access Hospital Conditions of Participation (CMS-3244-F)
The first rule revises the Conditions of Participation (CoPs) that hospitals and critical access hospitals (CAHs)
must meet in order to be eligible to participate in the Medicare and Medicaid programs. CMS estimates that
total hospital savings as a result of this rule will be approximately $940 million in the first year, and the agency
attributes the cost savings directly to reduced regulatory burdens rather than to reimbursement reductions.
CMS released a proposed rule in October 2011 revising the CoPs for hospitals and CAHs, and requested
stakeholder comment on its proposals.
CMS received over 1,700 public comments, a majority of which were submitted by representatives from the
hospital industry, physician groups, and non-physician practitioners. The agency noted in the rule that a number
of the commenters representing physician groups were disappointed with “what they viewed as the Agency’s
endorsement of the replacement of physicians with nurses and non-physician practitioners,” whereas many
non-physician practitioners expressed their support for proposals that would expand their roles “to the full
extent allowed under their respective State laws and regulations”. CMS addressed all comments in its responses
to the proposed provisions.
Noteworthy Provisions in the Final Rule
The final rule allows hospitals to maintain a single governing body responsible for all facilities within a hospital
system, but does not permit a multi-hospital system to be directed by a single medical staff. Hospitals therefore
must maintain a “single and separate” medical staff for each hospital in their system. The AHA has since
released a statement praising CMS for granting hospitals flexibility in defining a governing body while criticizing
its decision to deny the same privileges to a medical staff. The final rule also adds a provision requiring at least
one medical staff member to be on a hospital’s governing board, which has caused some hospitals to raise
conflict of interest and time commitment concerns regarding their board members.
In opposition to those commenters who supported permitting only physicians with specialized training to
administer certain medications, CMS ultimately decided to allow non-physician personnel to administer certain
intravenous medications and blood transfusions. The rule also finalizes its proposal to allow medical staff to
include non-physician practitioners, so long as they adhere to the requirements of their hospital and/or state.
Provisions Promoting Further Burden Reduction
 Allow CAHs to provide certain services (diagnostic and therapeutic, laboratory, radiology, and
emergency procedures) through contracts with other providers or temporary agencies rather
than being required to provide them directly.
 Allows nursing plans to be incorporated into an existing interdisciplinary plan rather than
necessitating a separate plan.
 Permits hospitals to use their own judgment when assigning staff directors to outpatient
departments based on the scope and complexity of their outpatient services, rather than
requiring a single Director of Outpatient Services position.
Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden
Reduction (CMS-9070-F)
The second rule on Medicare regulatory reform is expected to save an estimated $200 million in the first
year by eliminating duplicative, overlapping, and outdated regulatory requirements. The proposed rule,
released in October 2011, included 14 specific proposed reforms as well as a request for comments on
additional areas of future reform. Among the finalized provisions set forth by CMS, the rule will
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Eliminate various infection control instructions for Ambulatory Surgical Centers (ASCs); Medicaid
qualification standards for physical and occupational therapists; and duplicative requirements
for governing bodies of Organ Procurement Organizations;
Require only higher risk End Stage Renal Disease (ESRD) facilities to comply with the full National
Fire Protection Agency Life Safety Code requirements;
Eliminate the specific list of emergency equipment that must be maintained by ASCs;
Allow facilities, in conjunction with medical staff and their governing bodies, to develop policies
and procedures that specify emergency equipment appropriate to the services they provide;
Update e-prescribing technical requirements so Medicare Prescription Drug Plans meet current
standards; and
Replaces language referencing outdated personnel qualifications for Physical and Occupational
Therapists.
A complete outline of all changes to the provisions in both rules can be found in the attached tables.
2
Reform of Hospital and Critical Access Hospital Conditions of Participation (CMS-3244-F)
Provision
Governing body
(§482.12)
Patient’s rights
(§482.13)
Purpose
Proposed Rule
Final Rule
Reasoning
I. Revisions to Allow Flexibility and Eliminate Burdensome CoPs
Changes interpretation
“Governing body” can be a Same as proposed rule
Reflects CMS’s belief that hospitals
of the term “governing
single governing body that with one addition:
in a multi-hospital system can be
body” to reflect a
is legally responsible for all
effectively governed by a single
hospital’s current
facilities within a multiRequires that a hospital’s
governing body, and that a
organizational structure. hospital system.
governing body must
formalized link between these
include at least one
interdependent entities is
medical staff member.
appropriate.
Revises hospital
reporting standards in
cases of patient death
that involve soft twopoint wrist restraints
and no use of seclusion.
Establishes new
standards for staff
training and death
reporting.
Cases in which a patient
dies after being restrained
with soft, two-point wrist
restraints and was not held
in seclusion do not need to
be reported to CMS within
24 hours.
Hospitals have seven days
to notify CMS following the
date of patient death in
these cases.
Hospitals must make this
information available to
Same as proposed rule
with the following
revisions:
The new provision is also expected
to ensure regular communication
between a hospital’s governing body
and its medical staff(s).
Use of soft, two-point wrist
restraints is not proven to be
associated with patient death.
Clarifies that for those
deaths related only to
soft, two-point wrist
restraints the hospital
staff must record the
information regarding the
patient’s death in an
internal log or other
system.
The staff must document
3
Provision
Purpose
Proposed Rule
CMS in either written or
electronic form
immediately upon request.
In addition to telephone,
reporting can be done by
facsimile and electronic
reporting when available.
Medical staff
(§482.22)
Relaxes the restrictions
on personnel that can
be designated as a
member of a hospital
medical staff.
Physicians and nonphysicians can practice in a
hospital even if they are
not appointed to the
hospital’s medical staff;
however, they must meet
the requirements of their
specific hospital and
adhere to laws of their
state.
The list of professionals
eligible to serve as
Final Rule
Reasoning
in the patient's medical
record the date and time
the death was: (i)
Reported to CMS; or (ii)
Recorded in the internal
log or other system.
Each entry must
document the patient’s
name, date of birth, date
of death, name of
attending physician or
other licensed
independent practitioner
who is responsible for the
care of the patient,
medical record number,
and primary diagnosis(es).
Same as proposed rule
with the following
revisions:
Medical staff may also
include other categories
of non-physician
practitioners determined
as eligible for
appointment by the
governing body in
accordance with State
law, including scope-of-
Will allow hospitals flexibility in
developing “new and expanded
approaches to caregiving”.
Prior regulation was too
burdensome on non-physician
practitioners such as APRNs, PAs,
PTs, etc.
Intended to address healthcare
workforce shortages and provide
better care to medically
underserved communities.
4
Provision
Purpose
Proposed Rule
president is expanded to
include doctors of podiatric
medicine (DPMs).
Nursing services
(§482.23)
Modifies guidelines
related to nursing care
plans and the
administration of drugs,
biologicals, blood
transfusions, and
intravenous
medications.
Introduces a new policy
regarding self-
Nursing plans can be
incorporated into an
existing interdisciplinary
plan rather than being a
separate plan.
Extends capability to
prepare, administer,
document, and sign for
drugs and biologicals to
practitioners outside of
Final Rule
practice laws.
Medical staff must
examine the credentials of
all eligible candidates and
then make
recommendations on
medical staff membership
to the governing body.
A candidate who has been
recommended by
the medical staff and
appointed by the
governing body be subject
to all medical staff bylaws,
rules, and regulations, in
addition to the
requirements contained in
§482.22.
Same as proposed rule
with the following
revisions:
Drugs and biologicals may
be prepared,
administered,
documented, and signed
on the orders of other
practitioners not specified
under §482.12(c) only if
Reasoning
Most states laws already permit
DPMs to serve in hospital leadership
positions
Developing two separate plans was
overly burdensome on nursing staff.
Limiting categories of practitioners
able to administer drugs and
biologicals delayed treatment and
access to care.
Standing orders have been proven
to be effective when used by Rapid
Response Teams (RRTs), in ED
5
Provision
Purpose
administration of
certain medications for
patients and their
caregivers.
Proposed Rule
§482.12(c), provided they
adhere to State and
practice laws.
Drugs and biologicals can
be administered from
standing orders (preprinted and electronic).
Lifts the special training
requirement for blood
transfusions and
intravenous medications,
provided it is conducted in
accordance with state law
and hospital policy.
Medical record
services
(§482.24)
Changes the timeframe
in which a practitioner
must authenticate
orders.
Eases regulations
regarding standing
orders related to
Introduces a new provision
that allows hospitals to
create policies where
patients and their
caregivers can administer
certain medications.
Orders can be
authenticated by either the
ordering practitioner or
another practitioner
directly responsible for the
patient.
Removes 48-hour
Final Rule
such practitioners are
acting in accordance with
State law, including
scope- of- practice laws,
hospital policies, and
medical staff bylaws,
rules, and regulations.
A hospital must document
the administration of
medication “as reported
by the patient (or the
patient’s
caregiver/support person
where appropriate), in the
patient’s medical record.”
Same as proposed rule
with the following
revisions:
Reasoning
triage, for increasing immunization
rates, and for postoperative
recovery.
Blood transfusion and intravenous
medication training is standard
practice; additional training was
unnecessary.
New patient self-administration
provision would allow care to be
more patient-centered and
adaptable to patient needs.
48-hour timeframe requirement for
authentication of verbal orders was
overly burdensome on providers
and did not result in better or safer
patient care.
Clarifies that all orders,
must be dated, timed, and
authenticated promptly by Relaxing the requirements related
the ordering practitioner
to standing orders is intended to
6
Provision
Purpose
medical records.
Proposed Rule
timeframe requirement
and defers to hospital
policy or State law to
determine a timeframe.
Hospitals can use standing
orders in regards to
medical records services
provided all hospital
protocols were met.
Infection control
(§482.42)
Removes requirement
for hospitals to maintain
a log identifying
infection control
problems.
Eliminates the requirement
to maintain a separate
infection log.
Outpatient
services
(§482.54)
Changes personnel
requirements for
individuals in charge of
overseeing hospital
Allows hospitals to assign
one or more individuals to
be responsible for
outpatient services.
Final Rule
or by another practitioner
who is responsible for the
care of the patient “only if
such a practitioner is
acting in accordance with
State law,
including scope-ofpractice laws, hospital
policies, and medical staff
bylaws, rules, and
regulations.”
Same as the proposed
rule.
Same as proposed rule
with the following
revisions:
Reasoning
improve evidence-based medicine
practices and provide more
consistent care for patients.
Maintaining a separate infection log
in addition to hospitals’ infection
control surveillance systems was
redundant and burdensome.
we would also note
the universal support for this
proposal from several major
infection control groups, such as the
Infectious Diseases Society of
America (IDSA), the Association for
Professionals in Infection
Control and Epidemiology (APIC),
and the Society for Healthcare
Epidemiology of America
(SHEA).
Many hospitals have either
integrated their inpatient and
outpatient services or expanded
their outpatient departments, and
7
Provision
Transplant Center
Process
Requirements –
Organ recovery
and receipt
(§482.92)
Definitions
(§485.602) and
Provision of
services
(§485.635)
Purpose
Proposed Rule
Final Rule
Reasoning
outpatient departments. Hospitals can use their own
judgment when assigning
staff members based on
the scope and complexity
of their outpatient services.
Critical Access Hospitals
(CAHs) are exempt from
the requirement for
hospitals to have a single
director of outpatient
services.
therefore frequently assign more
than one individual to oversee
outpatient coordination. Requiring
an additional “overseer” was
creating unnecessary costs and
confusion associated with staffing.
Eliminates some
requirements for
transplant centers
related to blood type
verification
Same as proposed rule.
CfC blood type verification rules
were redundant of existing
transplant center an OPO
regulations, and therefore removing
them will not result in harm to
patient safety
Changes requirement
that CAHs must provide
certain services directly
Removes requirement that
the transplant team must
verify blood type before
organ recovery
Eliminates requirement
that CAH staff must
provide the following
services directly:
(1) certain diagnostic and
therapeutic services; (2)
laboratory services; (3)
radiology services; and (4)
emergency procedures.
Same as proposed rule.
Removing the unnecessary extra
verification will free up time and
resources for transplant centers
Not allowing CAHs flexibility to
contract with providers or
temporary agencies hinders their
ability to alleviate work force
shortages and most efficiently
coordinate their resources
Governing body or person
responsible for the CAH will
be responsible for all
8
Provision
Purpose
Pharmaceutical
services
(§482.25)
Technical change to
quality assurance
reporting requirement
Personnel
qualifications
(§485.604)
Revises definition of
clinical nurse specialist
Proposed Rule
Final Rule
services furnished by the
CAH whether furnished
directly or under contracts
or arrangements.
II. Clarifying Changes
The term “quality
Same as proposed rule.
assurance program” is
replaced with the term
“quality assessment and
performance improvement
program”. All drug errors,
adverse reactions, and
incompatibilities will be
subject to requirements of
QAPI programs listed under
§482.21.
A clinical nurse specialist is Changes the definition
now a “registered nurse
slightly:
licensed to practice nursing
in the State in which the
A clinical nurse specialist is
clinical nurse specialist
“a registered nurse and is
services are performed,
licensed to practice
that holds an advanced
nursing in
degree in a defined clinical the State in which the
area of nursing from an
clinical nurse specialist
accredited educational
services are performed in
institution”
accordance with State
nurse licensing laws and
regulations; and holds a
master’s or doctoral level
Reasoning
Reflects a more current term that
has been undertaken at hospitals to
ensure quality of care.
Adding the phrase “in
accordance with State nurse
licensing laws and regulations” will
ensure that an existing CNS will
continue to be evaluated based on
their State licensing laws and
regulations. CMS agreed with some
commenters who felt it would be
unfair to require national
certification for CNSs.
9
Provision
Surgical services
(§485.639)
Purpose
Clarifies that surgical
services are an optional
service for CAHs
Proposed Rule
Language of statue now
reads: “If a CAH provides
surgical services, surgical
procedures must be
performed in a safe
manner…”
Final Rule
degree in a defined
clinical area of nursing
from an accredited
educational institution.”
Same as proposed rule.
Reasoning
Surgical services are not mandatory
for CAHs as specified under section
1820(c) of the surgical services CoP
Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction (CMS-9070-F)
Provision
End-Stage
Renal Disease
(ESRD)
Facilities
(§494.60)
ASC
Emergency
Equipment
(§416.41
Purpose
Prior Regulation
Final Rule Regulation
I. Removes Unnecessary Burdensome Requirements
Lessens regulatory fire
ESRDs were subject to the
Mandatory compliance with
and safety requirements same set of standardized
NFPA 101 LSC regulations is
on ESRDs
Federal Life Safety Code
restricted to only those facilities
(LSC) and National Fire
that are adjacent to “high hazard
Protection Agency (NFPA)
occupancies” (i.e. close proximity
regulations as all other
to flammable liquids). All ESRD
providers.
facilities will be subject to state
and local fire codes and safety
standards.
Grants ASCs flexibility in ASCs were required to
deciding which
maintain emergency
emergency equipment is equipment compliant with
ASCs, their governing bodies, and
medical staffs can determine
which emergency equipment is
Reasoning
ESRDs have “non-residential
and unique characteristics”
that are not conducive to
standard CMS provider
regulations and were
duplicative of existing ESRD
regulations. There is a very low
risk of fire in outpatient dialysis
fires while the costs of
compliance (i.e. renovation)
with fire safety regulations
were disproportionately high.
Some of the equipment
required in prior regulations
was outdated or unnecessary
10
though
§416.43 and
§416.49
through
§416.52)
appropriate for their
facility rather than
requiring adherence to a
standardized list.
all items specified in CfC
414.44, including items such
as emergency call system,
ventilator assistance
equipment, manual
breathing bag, etc.
necessary and appropriate for
the procedures performed at
their facility. The equipment
must meet the acceptable
standards of practice of the ASC
industry.
to the services performed at a
particular ASC facility.
Revocation of
Enrollment
and Billing
Privileges in
the Medicare
Program
(§424.525)
Changes the period of
time a provider or
supplier whose
Medicare privileges
have been revoked must
wait before being reeligible for Medicare,
depending on reason for
revocation.
Changes guidelines
surrounding
Any Medicare provider,
supplier, delegated official,
or authorizing official that
has had their billing
privileges revoked was
barred from participating in
Medicare for a period of no
less than one year and no
longer than three years.
Medicare billing privileges
could be deactivated if
Medicare claims were not
submitted during a period of
12 consecutive months.
Eliminates the re-enrollment bar
when the provider or supplier
was removed on the basis of not
responding to revalidation
requests in a timely fashion. The
re-enrollment bar will remain for
instances when the Medicare
privileges revocation was more
serious.
Medicare billing privileges will
only be revoked for providers
and suppliers who fail to submit
the enrollment form (CMS-8551)
for individual physicians and nonphysician practitioners.
The re-enrollment bar in these
situations was deemed to be
an overly harsh consequence
because providers’ delayed
responses was usually
unintentional.
Deactivation
of Medicare
Billing
Privileges
(§424.540)
Medicare billing privileges
could be revoked if the
provider failed to furnish
complete and accurate
enrollment information
within 90 days of receiving
notification to do so.
Duration of
Agreement
for
Intermediate
Care
Facilities for
the
Changes time limits for
provider agreements for
Intermediate Care
Facilities for the
Intellectually Disabled
(ICFs/ID).
ICFs/ID provider agreements
were subject to Medicaid
annual time limits.
ICFs/ID were required to be
surveyed for compliance at
Deactivates rather than revokes
privileges If a provider or supplier
does not furnish requested
information within 90 days of
receiving notification to do so.
Removes time limited
agreements for ICFs/ID and
replaces them with open ended
agreements that will remain in
effect until the Secretary or a
state determines the facility does
There were numerous
instances in which
practitioners had valid reasons
for not submitting claims
during a 12-month period.
Prior reactivation procedure
was time-consuming and
overly burdensome for
Medicare contractors as well
as for providers and suppliers.
Changes to the survey and
certification period are
intended to allow ICF/ID
facilities flexibility in
scheduling and staffing, and
are expected to have a positive
11
Intellectually
Disabled
(§442.15
through
§442.109)
OMB Control
Numbers for
Approved
Collections of
Information
(§400.300
and
§400.310)
Removal of
Obsolete
Provision
Related to
Initial
Determinatio
n, Appeals,
and
Reopenings
of Part A and
Part B Claims
and
Entitlement
Determinatio
ns (§405.701
Adds a requirement
establishing time frames
for surveying ICFs/ID for
compliance.
least every 12 months on a
fixed schedule. If a facility
was surveyed earlier due to
a complaint, they were
required to complete a
survey again at the 12
month mark.
not meet conditions of
participation.
impact on their ability to
provide higher quality care to
patients.
ICFs/ID can be surveyed during a
12 – 15 month interval, which is
consistent with the schedule for
surveying nursing homes. If a
facility is surveyed earlier in that
time frame, for example at 10
months, they can use that survey
for their annual certification
rather than completing another
one at the 12-15 month mark.
II. Removes Obsolete or Duplicative Regulations or Provides Clarifying Information
Updates requirements
Required the collection and Removes entire requirement for An inventory of currently
for collection and
display of OMB-assigned
the collection and display for
approved CMS information
display of OMB control
control numbers
OMB control numbers
collections is displayed on the
numbers
public website:
www.reginfo.gov/public/do/PR
AMain, which is a more suitable
and efficient method to publish
this information.
Removes obsolete
All provisions concerning
Replaces these procedures
Replacing previous provisions
appeals process rules
initial determinations,
formally listed in subparts G and with one set of guidelines is
from the Benefits
appeals, and reopenings of
H with a set of new procedures
intended to remove confusion
Improvement and
Part A and Part B claims, and specified in subpart I.
and simplify the appeals process
Protection Act of 2000
determinations and appeals
for providers, suppliers, and
(BIPA) that have since
regarding an individual’s
beneficiaries.
been replaced with
entitlement to benefits
updated rules.
under Parts A and B, were
specified 42 CFR part 405
subparts G and H
12
through
§405.877)
ASC Infection
Control
Program
(§416.440)
Eliminates those
infection control
requirements for ASCs
that were listed under
the Environment CfC 42
CFR §416.44(a)(3)
E-prescribing
(§423.160)
Updates e-prescribing
foundation standards
for e-prescribing in the
Medicare Part D
program.
Under the physical
environment standard in 42
CFR 416.44(a)(3) ASCs were
required to establish a
program for identifying and
preventing infections,
maintaining a sanitary
environment, and reporting
the results to the
appropriate authorities
Required use of Health Care
Eligibility Benefit Inquiry and
Response Version 4010 and
4010A1 specified under the
HIPAA Electronic
Transaction Standards rule
for covered entities
conducting HIPAA
standards.
Required use of NCPDP
Telecommunication
Standard Implementation
Guide Version 5.1 and Batch
Standard Implementation
Guide Version 1.1 for
transmitting eligibility
inquiries and responses
between dispensers and
Part D sponsors.
Physical and
Occupational
Therapist
Updates language
regarding qualifications
Current provider
qualifications for physical
Completely removes the
Environment CfC
ASCs are already subject to
infection control requirements
in the Infection Control CfC
under §416.51. Requiring
additional compliance under
the Environment CfC for the
same conditions was duplicative
and confusing.
Covered entities that conduct
HIPAA standards must now use
Health Care Eligibility Benefit
Inquiry and Response, Version
5010 by January 1, 2012.
Maintains consistency with
current HIPAA transaction
standards
Requires NCPDP
Telecommunication Standard
Implementation Guide Version
D.0 and Batch Standard
Implementation Guide Version
1.2 for retail pharmacy drug
transactions including health
care claims or equivalent
encounter information,
eligibility for a health plan,
referral certification and
authorization, and coordination
of benefits.
Removes language referencing
outdated personnel
Prior regulations contained
outdated terminology
13
Qualifications
(§440.110)
for physical therapists
and occupational
therapists participating
in Medicare and
Medicaid.
therapists are located under
42 CFR 440.110(a)(2) and for
occupational therapists
under 440.110(b)(2).
qualifications under §440.110 of
current Medicaid regulations
and replaces it with an
instruction to cross-reference
updated qualifications under
§484.4.
Definition of
Donor
Document
(§486.302)
Updates the definition
of “donor document”
Previous regulation
identified an “individual’s
choice” but not does allow
the individual to be more
specific should they choose
to include more detail
regarding which tissues
and/or organs they wish to
donate.
New definition of donor
document will be “any
documented indication of an
individual’s choice regarding his
or her wishes concerning organ
and/or tissue donation that was
made by that individual or
another authorized individual in
accordance with any applicable
State law.”
Administratio
n and
Governing
Body
(§486.324)
Corrects typographical
error (a duplicative
paragraph) in 71 FR
30982
Requirement
for Enrolling
in the
Medicare
Program
(§424.510)
Corrects typographical
error (an incorrect
reference) in
§424.510(a)
Redefining
Discontinues use of
Incorrect reference in
paragraph (c) referencing
the effective date for
reimbursement for
providers and suppliers
seeking accreditation
concerning professional
organizations and did not deal
with professionals who received
training outside of the United
States. Updating the definitions
will allow fewer PT and OT
professionals to be excluded
from providing Medicaid
services and “strengthens the
consistency of standards across
Medicare and Medicaid”.
New definition reflects the
various new choices an
individual has when indicating
they wish to be a donor. New
definition also includes the
“executed by the patient”
language to emphasize the
voluntary nature of donation.
Removes paragraph (e) which is
duplicative of paragraph (d)
immediately preceding it
Error correction
Changes the reference to
paragraph (d) which contains
information on enrollment
requirements
Error correction
III. Responds to Stakeholder Concerns
The term “recipient” was
“Beneficiary” means all
Reflects terminology that is
14
the Term
“Beneficiary”
(§400.200
through
§400.203)
term “recipient” and
replaces it with
“beneficiary”
throughout 42 CFR
chapter IV.
used interchangeably with
the term “beneficiary”
individuals who are entitled to
or eligible for Medicare or
Medicaid services.
already widely used
Replace the
Terms
“Mental
Retardation”
and “Mentally
Retarded”
with
“Intellectual
Disability”
and
“Intellectuall
y Disabled”
(throughout
CFR title IV)
Updates terminology
regarding intellectually
disabled individuals.
The terms “mentally
retarded” and “mental
retardation” were used in
statutory language.
“Intellectually disabled” will
replace “mentally retarded” and
“intellectual disability” will
replace “mental retardation”.
“Individuals with Intellectual
Disabilities” will replace all of
the following terms: “the
mentally retarded”; “mentally
retarded persons”; and
“mentally retarded individuals”.
Also we clarify that “individuals
with intellectual disabilities or
developmental disabilities” will
replace “mentally retarded or
developmentally disabled.”
After public comment from
provider and advocate
organizations, CMS wanted to
be consistent with “Rosa’s Law”
(Pub. L. 111-256) that amended
terminology related to
intellectual disabilities in this
way.
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