Home Health & Hospice Week

CMS should nix statewide bans, rep says.

Although the Office of Management and Budget hasn’t yet approved the form for requesting an exception to the home health agency moratoria, at least one home health agency has tried it.

Reminder: The Centers for Medicare & Medicaid Services extended its statewide moratoria on new home health agencies, which it put into place last August, for another six months in Florida, Illinois, Michigan, and Texas, the agency says in a July 28 Federal Register notice (see Eli’s HCW, Vol. XXVI, No. 29).

In the moratoria extension notice last year for the statewide expansion, CMS said it would offer exceptions through a “Provider Enrollment Moratoria Access Waiver Demonstration.”

However, a year later, the application form is still in the Paperwork Reduction Act process and awaits OMB approval, a CMS spokesperson tells Eli. The waiver is supposed to afford “possible exceptions to the moratoria to ensure that beneficiary access to care is not adversely impacted,” CMS says on its waiver demo site. “Authorization of an exception would be based primarily on beneficiary access to care but would also depend upon passing the enhanced screening measures.”

Despite the fact that CMS hasn’t authorized the form, at least one HHA has tried to apply for a waiver under the process, the CMS source confirms. But any requests haven’t been successful.

The deck is stacked against agencies pursuing an exception, says William Dombi, VP for Law with the National Association for Home Care & Hospice and newly appointed NAHC President.  “The moratorium waiver process that CMS established is a visit into an unknown jungle,” Dombi tells Eli. “CMS has not set out consistent and objective standards to qualify for a waiver. That makes it virtually impossible for an HHA applicant to effectively seek a waiver,” Dombi asserts.

Scrap it: “CMS can definitely improve the moratoria standards by targeting service areas rather than entire states,” Dombi argues. “In doing so, CMS would reduce the need for a waiver process as well.”

Note: See more about the waiver at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/ProviderEnrollmentMoratorium.html.