The Commonwealth of Massachusetts

Executive Office of Health and Human Services

Department of Public Health

250 Washington Street, Boston, MA 02108-4619

To: Commissioner Monica Bharel, MD and Members of the Public Health Council

From: Eric Sheehan, JD, Director of the Bureau of Health Care Safety and Quality

Date: December 14, 2016

RE: Informational Briefing on the Proposed Rescission of 105 CMR 131.000, The Operation of the Advocacy Office.

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I. Introduction

The purpose of this memorandum is to provide the Public Health Council (PHC) with information about the proposed rescission of 105 CMR 131.000, The Operation of the Advocacy Office.

This rescission is proposed as part of the regulatory review process, mandated by Executive Order 562, which requires the Department of Public Health (DPH), and all other state agencies, to undertake a review of each and every regulation currently published in the Code of Massachusetts Regulations under its jurisdiction.

The Bureau of Health Care Safety and Quality (BHCSQ), within DPH, proposes rescinding this regulation because it is duplicative of state and federal regulations, and is not essential to the health, safety, environment or welfare of the Commonwealth’s residents.

II. Background

105 CMR 131.000 sets forth standards and requirements for the receipt, investigation and resolution of complaints received by the Advocacy Office and for the conduct of discharge plan reviews of Medicare patients only. It applies only to acute care hospitals and provision of services to Medicare beneficiaries.

The current language of 105 CMR 131 is attached to this memorandum.

III. Proposed Regulations

The Department proposes that this regulation be rescinded in its entirety.

The underlying statute, section 51D of chapter 111 of the General Laws, prohibits any acute hospital discrimination in admission, services, or discharge against any patient who is a Medicare beneficiary. The statute directs the Department to establish and operate the Advocacy Office to receive complaints of alleged violations of this provision. The Advocacy Office is part of the Bureau of Health Care Safety and Quality’s Complaints Unit.

These regulations are unnecessary because they are duplicative of hospital licensure regulations and statutes prohibiting discrimination. Existing Department regulations apply to all patients, not just Medicare patients. A patient who is aggrieved by a hospital can seek assistance through the Department’s Complaint Unit or CMS’s Quality Improvement Organization. As such, this regulation is duplicative and, therefore, not mandated by law.

This statute is sufficiently detailed and prescriptive such that additional regulation is not required to operate the program as necessary to ensure the same patient protections. With the current statute in place, this regulation is not essential to the health, safety, environment or welfare of the Commonwealth’s residents.

IV. Summary

Staff intends to conduct the public comment hearing and hopes to return to the PHC to report on testimony and any recommended changes to this proposal. Following final action by the PHC, the Department will be able to file the final rescission with the Secretary of the Commonwealth.