Hospice Community Responds to Proposed Survey Reforms in CMS Home Health Rule

Hospice News / By Jim Parker
 
The National Hospice & Palliative Care Organization (NHPCO) in consultation with its members have submitted comments to the U.S. Centers for Medicare & Medicaid Services (CMS) on hospice provisions within the proposed 2022 home health rule. If made final the rule would overhaul the survey and regulatory enforcement processes that CMS uses to evaluate hospices.
 
CMS is taking these actions pursuant to the Consolidated Appropriations Act of 2021. Congress included these provisions in response to July 2019 reports on hospice quality from the Office of the Inspector General (OIG) at the Department of Health and Human Services (HHS).
 
“While the intent of the proposed rule is sound, many of the specifics raise concerns,” said NHPCO’s President and CEO Edo Banach. “NHPCO’s recommended revisions to the proposed rule would protect patient interests, bring hospice regulations in line with regulations governing other post-acute care providers, and improve standardization and consistency in hospice accreditation and surveying systems.”
 
If made final, the new regulations would require multidisciplinary survey teams, prohibit surveyor conflicts of interest and update the surveyor training process. The agency expects that implementation of these proposals would cost an estimated $5.5 million annually. The rule would also mandate that surveys be conducted more frequently, no later than 36 months following the providers’ previous survey.
 
Among the numerous elements contained in the proposal is the creation of a Special Focus Program (SFP) with the power to impose enforcement remedies against hospices with poor performance on regulatory or accreditation surveys. The agency also has plans to implement a hospice program complaint hotline through which the public can report issues to CMS.
 
Hospices flagged by the proposed Special Focus Program would be surveyed every six months rather than the current three-year cycle. The SFP would have the authority to impose fines, suspend reimbursement, appoint temporary management to bring the hospice into compliance, or revoke a provider’s Medicare certification altogether.

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