Clinical engineering departments across the country had their holidays brightened by an unexpected gift from the Centers for Medicare & Medicaid Services (CMS). In a December 20 memo, the agency relaxed its restrictive policies on preventive maintenance of medical equipment, and will now allow well-documented alternatives to manufacturers’ service recommendations for many types of devices.
In an informal poll of 24×7 readers, healthcare technology management professionals expressed nearly unanimous appreciation for the new policy. As one put it, the revised approach “leaves more room for local control of procedures with less fear of litigation, even with high risk devices.” Another said, “It allows common sense and intelligence to be part of the process.”
Most also recognized that the new guidelines will have a much less severe impact on clinical engineering budgets than would have been imposed by the December 2011 rules. Not only will the new approach reduce the number of PMs required, as one biomed noted, but it will also mean that departments “will not have to purchase specific test equipment due to manufacturer’s specifications.”
The general sense of relief that CMS has moderated the more restrictive old policy doesn’t mean that many biomeds are completely satisfied with the new one. “The original directive and the amended one [are], in my opinion, still a lawyer’s dream to hold servicers to very lofty service standards,” said one respondent. “This in a time when medical facilities need to reduce costs, not add [them],” he continued. “While realizing there will always have to be guidance for such things, rigid requirements from manufacturers, CMS, and other agencies are another factor driving our rapidly growing healthcare costs.”
While the new policy is an improvement, said another reader, it “is still vague on important points.” For instance, he asked, “What constitutes ‘qualified personnel’, or ‘a sufficient amount of maintenance history’?” Another wrote, “In my opinion, CMS should make a broader requirement giving latitude akin to The Joint Commission with all equipment. All equipment is different and resides in differing environments and utilization methods.”
While most CE managers would probably have preferred to avoid the uncertainty of the last two years, at least one sees a positive side to the experience, saying that “it may have raised awareness of how maintenance procedures are properly performed.” And, he continued, “Sometimes in life it takes a little scare to correct what could be a problem.”