CMS updates home healthcare rules for Medicare, Medicaid

Dive Brief:

  • CMS issued a final rule this week setting minimum standards for a range of services delivered by home health care providers, including nursing, physical therapy and occupational therapy.

  • The final rule includes requirements to improve information communication to patients and caregivers about services provided and to improve coordination among home healthcare providers and other providers.

  • Nearly 12,600 home health agencies across the nation provide services to more than 5 million patients through Medicare and Medicaid, according to CMS.

Dive Insight:

It has been a long time coming since draft proposal was introduced in 2014, but CMS has finally issued a final rule outlining home health agency requirements for participation in Medicare and Medicaid. The final rule states that requirements “focus on a patient-centered, data-driven, outcome-oriented process that promotes high quality patient care at all times for all patients.”

Medicare and Medicaid conditions of participation had not been addressed in around two decades. Before the most recent draft proposal was published about three years ago, CMS had issued a proposed rule in 1997. However, only a portion of its contents, the Outcome and Assessment Information Set, was finalized.

As the population continues to age, it is likely that demand for home health services will grow. However, as they are more increasingly relied upon, home health agencies will likely be more closely monitored by the government for compliance, fraud and safety issues. To wit, the Department of the Office of the Inspector General declared that home health agencies were particularly vulnerable to fraud.

Filed Under: Policy & Regulation
Top image credit: Sm+RT Homes, LLP