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CMS Releases Final Rule Revising Conditions of Participation for Home Health Agencies

health care written informationOn January 9, 2017, the Centers for Medicare & Medicaid Services (“CMS”) issued final rules that establish minimum standards for home health agencies (the “Rules”). According to CMS, the Rules are intended to improve the quality of health care services for Medicare and Medicaid patients and strengthen patients’ rights.

The Rules, which were published in the Federal Register on January 13, 2017, come more than two years after a draft proposal was introduced in October 2014. The Rules are mostly adopted as proposed, with a few clarifying changes. The Rules will become effective on July 13, 2017. This means agencies have less than six months to make changes necessary to comply with the revisions.

According to a press release issued by CMS, “[t]hese changes are an integral part of CMS’ overall effort to improve the quality of care furnished through the Medicare and Medicaid programs, while streamlining requirements for providers.” The Rules include the following changes to the Medicare and Medicaid Conditions of Participation for home health agencies:

  • a requirement that assures that patients and caregivers have written information about upcoming visits, medication instructions, treatments administered, instructions for care that the patient and caregivers perform, and the name and contact information of a home health agency clinical manager;
  • a requirement for an integrated communication system that ensures that patient needs are identified and addressed, care is coordinated among all disciplines, and that there is active communication between the home health agency and the patient’s physician(s);
  • a new infection prevention and control requirement that focuses on the use of standard infection control practices, and patient/caregiver education and teaching;
  • an expanded patient care coordination requirement that makes a licensed clinician responsible for all patient care services, such as coordinating referrals and assuring that plans of care meet each patient’s needs at all times;
  • a requirement that OASIS data be transmitted in accordance with current CMS transmission policy, which requires HHAs to transmit data using electronic communications software that complies with the Federal Information Processing Standard;
  • revisions to the definition of a home health agency "branch" by adding requirements relating to supervision and administrative control, and removing the requirement that the branch office be "sufficiently close" to the parent agency;
  • elimination of home health agency "subunits"; and
  • new personnel qualifications for home health agency administrators and clinical managers.

The complete Rules, which are 374 pages long, are available in the Federal Register. Agencies that are affected should begin reviewing the Rules immediately in order to begin the process of implementing necessary changes to policies and procedures by the July 13, 2017 compliance deadline. If you have any questions about the Rules, and/or would like to discuss the impact of the Rules on your business, please contact Jennifer Van Regenmorter or Julie Hamlet.

Categories: Medicare/Medicaid, News & Events, Providers

 has particular expertise in health law and she represents providers with emphasis in the areas of physicians, hospice, home care and long term care, including one of the country’s largest long-term care organizations. She has a vast array of experience in teaming with providers in the areas of regulatory compliance and contracts. 

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