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Policy Snapshot: Health Equity Standards and Regulations for Hospitals

June 30, 2023

The Centers for Medicare & Medicaid Services (CMS) mandated new equity standards or regulations for hospitals under the Inpatient Quality Reporting Program, effective October 2022. Hospitals that do not meet these requirements see a 25 percent reduction in Medicare payments, and data from the program are publicly reported on the Care Compare website.

Health equity–related requirements include screening for social drivers of health (SDOH), screen positive rate for SDOH, and a hospital’s commitment to health equity.

The agency also implemented new quality requirements for physicians, starting Jan. 1, 2023. These include a quality measure for screening for social drivers of health and two new equity improvement activities: actions to improve care for LGBTQ+ patients and creating and implementing a language access plan. Physicians face reimbursement reductions for failing to meet the new requirements.

Additionally, CMS now requires hospitals to receive certification of compliance with national health and safety requirements, known as Conditions of Participation. Hospitals primarily receive accreditation by independent accrediting bodies, such as the Joint Commission, the National Committee for Quality Assurance, and DNV.

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