Home Health & Hospice Week

Reverting to ‘normal’ may be more like starting from scratch.

The drawbacks of returning to pre-COVID operations and policies may seem obvious, but beware of some downsides you may not expect.

For instance: “The fact that the pandemic lasted for over three years presents a special challenge for compliance officers,” warns the Health Care Compliance Association. Due to massive turnover in healthcare during the public health emergency, “a significant percentage of the workforce can’t just go back to business as usual because they were not around when the flexibilities were not in effect,” HCCA points out.

The result is that compliance officers and other management “will have a significant lift to educate their staff on changes required with the expiration of the PHE,” the association cautions.

And what exactly is changing isn’t always crystal clear “Throughout the PHE various waivers, regulations, enforcement discretion, and sub-regulatory guidance were utilized to ensure access to care and give health care providers the flexibilities needed to respond to the PHE,” notes the National Association for Home Care & Hospice. “Some of these flexibilities became permanent over the years, some have been extended and some will end after May 11,” NAHC says.

You’re not alone if you don’t know everything for sure. “The process of unwinding the extensive waivers and flexibilities is complex,” allow attorneys Jenna Godlewski and Alice V. Harris with law firm Maynard Nexsen.

“NAHC still has questions/concerns about expectations around provider responsibilities for some of the flexibilities,” the trade group says. “We are reaching out to [the Centers for Medicare & Medicaid Services] and will update providers when we have more information,” it pledges.

Regardless of the final details, expect more work than usual ahead. “As part of the emergency preparedness cycle, returning to normal operations is the ‘Recovery Phase,’” points out the Accreditation Commission for Health Care on its website. “Many organizations have been slowly reverting back to normal over the past several months,” ACHC notes. But “some areas of the country may shift from a pandemic response to an endemic response,” it observes.

“The shift in post-PHE requirements presents increased challenges for compliance professionals, who must equip staff to adjust again to a new — but once familiar — normal,” HCCA concludes.

“Healthcare providers are well advised to step back to confirm historical and prospective compliance … as the pandemic-era regulatory flexibilities … come to an end and these regulatory regimes return to normal,” urge attorneys Albert Shay and Felicia Alexander with Morgan, Lewis & Bockius in online analysis.

“Educate your providers and staff on the ‘new’ policies and procedures and explain the importance of swift implementation,” Godlewski and Harris recommend. “Conduct internal audits … to ensure the waivers and/or flexibilities are no longer being used,” they urge in online analysis.

Why? “It is very likely CMS will conduct audits in the future to ensure that providers are no longer utilizing waivers and flexibilities that have been terminated,” Godlewski and Harris warn. “To avoid overpayments, civil monetary penalties, provider enrollment issues, administrative liability, and False Claim Act liability, providers must react quickly to be compliant with CMS policies that are shifting to the post-pandemic world,” they stress.