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CMS Answers Questions on Provisional Enhanced Oversight of New Home Health Agencies

Posted on Sunday, March 31, 2019 8:49 PM

Recently, CMS announced that new Home Health Agencies (HHA) would be subject to a provisional period of enhanced oversight.  This period will put the HHA on RAP suppression from 30 days to one year.  Below is the clarification NAHC received on specific questions and concerns they had.

How is new enrolling HHA defined?

A new enrolling HHA and HHA’s undergoing a change of ownership (CHOW) and/or 100% CHOW.  This applies to new HHAs that will be issued an approval or approval recommendation letter with a date on or after March 7, 2019.

Will the RAP suppression apply in a CHOW situation where the buyer accepts the provider agreement of the purchased agency (i.e. no change in CCN)?

CMS: RAP suppression may apply to both CHOW scenarios. The HHA will be notified in the approval letter by the MAC.

What criteria will be used to remove an agency from the enhanced oversight (RAP suppression)?

CMS: Under the enhanced oversight authority there is no required criteria for the removal of the RAP suppression other than the up to 1 year maximum. CMS will review all factors when establishing the enhanced oversight period and apply discretion on a case by case basis if less than 1 year is determined.

Source: NAHC


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