HHAs Should Make Use of Delay in New Medicare Rules

Karen A. Jeffers and Margaret A. Bartiromo

Now that the Centers for Medicare & Medicaid Services (CMS) have published a Final Rule delaying the effective date of the revised Medicare Conditions of Participation (CoP) for home health agencies (HHAs) until January 13, 2018, HHAs are advised to use the next few months to prepare for the changes ahead.

In response to its proposal in April to delay the effective date (see our prior blog), CMS received favorable responses from a large number of HHAs, which reported that the revised CoP include numerous changes that require time for planning, testing, training and implementation. For example, the new CoP revise personnel qualification requirements, add new patient rights and impose new quality assessment and infection control obligations on HHAs.

The new CoP also require HHAs to undertake data-driven performance improvement projects (PIPs). When CMS first issued the revised CoP in January, it had provided a six-month phase-in period for these PIPs in recognition of the time it would take HHAs to collect the data necessary to identify areas for performance improvement. CMS has stated that it continues to believe that a phase-in period is appropriate and has set an effective date of July 13, 2018 for the new PIPs. HHAs are advised to begin identifying areas for improvement now so that they can implement effective PIPs next July.

HHAs are cautioned not to wait for official guidance before taking steps to comply with the new CoP. CMS has stated that revisions to its Interpretive Guidelines (currently found in Appendix B of the Medicare State Operations Manual) are currently underway and that it expects to release a preliminary draft for informal input in the fall, with a final version available in December. However, CMS has warned that a delay in the release of revised Interpretive Guidelines would not require a further delay of the effective date of the CoP.

For more information on how the new CoP affect HHAs in Connecticut, please contact Karen A. Jeffers (, Margaret A. Bartiromo ( or Karen P. Wackerman (

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