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Home Health CoP Guidelines Expected Soon

Posted on Thursday, March 22, 2018 4:30 PM

New Conditions of Participation (CoPs) for Medicare have been in effect since January but official interpretive guidelines (IGs) from the Centers for Medicare & Medicaid Services (CMS) have yet to be released. This has left some home health providers concerned, as the cost to individual providers to comply has been estimated to be $30,000, according to CMS figures. However, the regulations were not a total overhaul, as some other health care sectors experienced.

“There was a lot of concern about the fact that we did not have the interpretive guidelines out as of July in 2017,” Peggye Wilkerson, director, continuing care group, quality and safety oversight at CMS, said during a session on regulatory updates at the National Leadership Conference in Washington, D.C. on March 9th. “Technically, you don’t have to have interpretive guidelines to do surveys. You can do directly from the regulation. It was technically not an impediment to the new CoPs going live.”

The new guidelines are expected to come out in the next six to eight weeks, according to CMS officials. Providers did have time to review the new CoPs, and CMS even delayed the implementation by six months. Draft IGs were also released in October of 2017. 

The IGs will likely clarify some of the requirements and specific language within the regulations, but their main purpose is to help surveyors, according to CMS officials. Surveyors will also base their work on the regulations, not the guidelines.

CMS also will not impose civil monetary penalties (CMPs) for the first year of the new CoPs, giving agencies some reprieve as they take steps to be compliant.

“The provider community was concerned the surveyors might not be as familiar with these regulations and CMPs might not be appropriate,” Wilkerson said. “We didn’t really agree with that but because there was significant provider concern, we agreed to do a one-year moratorium of the CMPs…We will impose the CMPs if there is an immediate jeopardy.”

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