The AMA's June 13 letter says "some hospital groups are attempting to force changes to the governing body and medical staff provisions of the final rule" and working to make those changes through revisions in interpretive guidelines. "We strongly urge CMS to ensure that this process is transparent and does not contravene the provisions of the final rule"
The AMA, however, says the language was written in the proposed rule and "in fact, many stakeholders discussed the issue of a single medical staff in their comments on the proposal."
Cecil Wilson, MD, the AMA's immediate past president, says that "if you do not have on a hospital governing board "a physician who can help make decisions related to quality and safety, I think the possibility and risk of making decisions which are not well-informed increases. Not to have that (input) would put these boards at risk of making decisions, which were not in the best interests of the hospital or for the patients."
CMS officials say they are caught in the middle. "We're aware of the concerns around this rule and are taking them seriously," CMS spokesman Brian Cook wrote in an e-mail. "We are looking at how to avoid any unnecessary conflicts for facilities, while also allowing medical staff’s perspective on quality of care to be heard by an organization's governing board."