CMS Issues Final Rule to Modernize Home Health Conditions of Participation

Earlier this week the Centers for Medicare & Medicaid Services (CMS) released a final rule (CMS-3819-F) that set minimum standards for home health agencies as Conditions of Participation (CoPs). According to CMS the rules are aimed at improving the quality of care for beneficiaries and boosting patients’ rights.

There are 39 home health agencies providing Skilled nursing care, physical therapy, occupational therapy and services to roughly 266,000 Medicare and 187,000 Medicaid beneficiaries in New Hampshire, according to CMS.

“Today’s announcement is the first update in many years to Medicare and Medicaid home health agency rules and reflects current best practices for in-home care, based on recommendations from stakeholders and medical evidence,” said Dr. Kate Goodrich, CMS’s chief medical officer and the director of its Center for Clinical Standards, in a statement announcing the rule.

The 374-page rule sets out conditions for home health agencies to be able to participate in federal Medicare and joint federal-state Medicaid programs. They include requirements in training, competency and patient rights.

The final rule requires that patients and caregivers receive written information about services, such as instructions for medications or contact information for clinical managers at home health agencies.

Other requirements focus on integrated, coordinated care. The rule expands a requirement for patient care coordination that designates a licensed clinician as responsible for services such as coordinating referrals. An integrated communication system is another requirement, aimed at ensuring that a home health agency and patient’s physician communicate with each other.

“We are revising the home health agency requirements to focus on a patient-centered, data-driven, outcome-oriented process that promotes high quality patient care at all times for all patients,” the final rule says.

According to CMS, this regulation change is focused on assuring the protection and promotion of patient rights; enhancing the process for care planning, delivery, and coordination of services; and building a foundation for ongoing, data-driven, agency-wide quality improvement.

Several principles guided the new conditions of participation, according to the rule. One was to develop more continuous, integrated care processes. Another was to use a “patient-centered, interdisciplinary approach” that recognized the contributions of “various skilled professionals.” The new conditions for home health agencies also tried to eliminate administrative requirements that were not seen as helping patients.Home health agencies must meet these requirements and others laid out in the rule to be eligible to provide services to Medicare and Medicaid beneficiaries. The regulations are set to take effect July 13, 2017.

CMS Issues Final Rule to Modernize Home Health Conditions of Participation