FROM MEDICARE: The Centers for Medicare & Medicaid Services (CMS) have finalized HHA care policies and rules governing HHAs that will improve the quality of home health care services for Medicare and Medicaid patients and strengthen patients’ rights. These Medicare and Medicaid Conditions of Participation are the minimum health and safety standards a HHA must meet in order to participate in the Medicare and Medicaid programs.

HH care allows patients to receive needed health care services within the comfort and safety of their own homes. Patients receive coordinated services ranging from skilled nursing to physical therapy to medical social services, all under the direction of their physician. Currently, there are more than 5 million Medicare and Medicaid beneficiaries receiving HHA care from nearly 12,600 Medicare and Medicaid-participating home health care agencies nationwide.

“Our priority is to ensure that Medicare and Medicaid beneficiaries who receive health services at home get the highest level of patient-centered care from HHA,” said Kate Goodrich, MD, CMS Chief Medical Officer and Director of the Center for Clinical Standards and Quality for CMS. “Today’s announcement is the first update in many years to Medicare and Medicaid HHA rules and reflects current best practices for in-home care, based on recommendations from stakeholders and medical evidence.”

These changes are an integral part of CMS’ overall effort to improve the quality of care furnished through the Medicare and Medicaid programs, while streamlining requirements for providers. The final rule includes home health care policies:

•  A comprehensive patient rights condition of participation that clearly enumerates the rights of HH agency patients and the steps that must be taken to assure those rights.
•  An expanded comprehensive patient assessment requirement that focuses on all aspects of patient wellbeing.
•  A requirement that assures that patients and caregivers have written information about upcoming visits, medication instructions, treatments administered, instructions for care that the patient and caregivers perform, and the name and contact information of a HH agency clinical manager.
•  A requirement for an integrated communication system that ensures that patient needs are identified and addressed, care is coordinated among all disciplines, and that there is active communication between the HH agency and the patient’s physician(s).
•  A requirement for a data-driven, agency-wide quality assessment and performance improvement (QAPI) program that continually evaluates and improves agency care for all patients at all times.
•  A new infection prevention and control requirement that focuses on the use of standard infection control practices, and patient/caregiver education and teaching.
•  A streamlined skilled professional services requirement that focuses on appropriate patient care activities and supervision across all disciplines.
•  An expanded patient care coordination requirement that makes a licensed clinician responsible for all patient care services, such as coordinating referrals and assuring that plans of care meet each patient’s needs at all times.
•  Revisions to simplify the organizational structure of HHA agencies while continuing to allow parent agencies and their branches.
• New personnel qualifications for HHA administrators and clinical managers.

The final rule can be viewed at the Federal Register website at: https://www.federalregister.gov/public-inspection/current

 Get Paid Faster With Perfect Medicare Final Claims