Home Health & Hospice Week

CMS to use enforcement discretion.

Home health agencies may get a little leeway on certain Medicaid requirements that took effect in 2016, but haven't yet been enforced - including for face-to-face requirements.

"There may continue to be state-specific administrative challenges associated with implementing certain provisions of the Medicaid Home Health final rule" published in February 2016 with an effective date of July 2016. And "there is confusion surrounding state compliance deadlines," the Centers for Medicare & Medicaid Services says in an April 5 Center for Medicaid and CHIP Services Informational Bulletin.

"As any modifications or changes to the ... Final Rule will generally necessitate rulemaking as required by the Administrative Procedure Act (APA), CMS intends to use our enforcement discretion to focus on working with states to achieve compliance with provisions of the Medicaid Home Health final rule if states are unable to meet compliance deadlines. This use of enforcement discretion will be applied based on state-specific facts and circumstances and focused on states' specific needs," the bulletin says.

"We welcome CMS working with states to apply more flexibility with the Medicaid face-toface requirement," NAHC President William Dombi says in the trade group's newsletter.

The bulletin also emphasizes that CMS will adhere to not allowing states to implement a homebound requirement for Medicaid home health, nor a requirement for nursing or therapy service need.

"We very much support CMS having a strong stance on enforcing compliance with regulation that prohibit a homebound requirement for home health patients," Dombi adds.

The bulletin is at www.medicaid.gov/federalpolicy-guidance/downloads/cib040518.pdf.