While the government shutdown has paused Medicare functions that impact the home health industry, including the hospital-at-home waiver and telehealth flexibilities, some Medicare complaint investigations will continue.
The Centers for Medicare and Medicaid Services stated in a revised memo on Tuesday that complaint investigations alleging harm are considered essential functions and will continue during the government shutdown. Certain federal enforcement actions resulting from these surveys should still be imposed and some revisit surveys may still be approved.
“During a lapse in appropriation, it is not legal for CMS or states (acting on CMS’ behalf) to carry out federal survey and certification activities beyond those deemed to be ‘excepted activities,’” the memo read. “Excepted activities are those related to the safety of human life or protection of property. If states carry out non-excepted functions under the auspices of the state government, they should not represent these as federal survey and certification activities.”
Recently completed surveys that did not identify immediate jeopardy or patient or resident harm will be held until the federal government is funded. Any immediate threats to a Medicare beneficiary’s life or safety should still be addressed, CMS wrote.
“We deeply regret the necessity to curtail federal survey and certification functions,” the memo read. “State licensure functions and state enforcement activities under state law are, of course, not constrained by any federal government shutdown.”
Some revisit surveys are still authorized to continue, including those that are necessary to ensure that immediate jeopardy or patient harm has been addressed.
Standard Medicare-funded recertification surveys will not be performed during the shutdown, including statutorily mandated surveys that impact home health agencies, except for hospice surveys funded through the Consolidated Appropriations Act (CAA) of 2021.
Minimum data set (MDS) or OASIS activities should not be conducted, CMS said, except for what is necessary to maintain provider reporting. Initial surveys and initial certifications should not be conducted.
Complaint surveys are the most challenging type of survey for home health agencies, experts previously told Home Health Care News, and require comprehensive preparation protocols.
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