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CMS Authority to Impose Monetary Sanctions for Home Health Agencies

Last summer, CMS began implementing the first phase of sanctions for home health providers that are found to be out of compliance with the Medicare Conditions of Participation (CoPs). Effective, July 1, 2013, CMS began imposing non-monetary sanctions, such as a directed plan of correction,where CMS staff directs the organization’s plan of correction; directed in-service training, where CMS requires mandatory employee training; and/or directed temporary management, where CMS may bring in staff of their choice to manage the operations at the organization’s expense.

Effective July 1, 2014, CMS now has the authority to impose civil monetary penalties for a home health agency for either the number of days the agency is not in compliance, or for each instance the agency is not in compliance. Organizations accredited by CHAP are generally exempt from these sanctions, which can range up to $10,000 per day.

Because the Medicare CoPs are embedded in the CHAP Standards of Excellence, organizations that meet or exceed the CHAP Standards are found to be comprehensively in compliance with the CoPs.  As well, CHAP’s deeming authority for home health from CMS ensures CHAP-accredited providers are exempt from routine CMS site visits, with the exception of those due to complaints or the required sample validation surveys. Fewer CMS site visits essentially translates to less risk of any CMS-directed sanctions being imposed as a result of a CMS survey.  

In addition to our consultative and educational site visit process, all organizations contracted with CHAP have access to a wealth of compliance information, from the CHAP Standards of Excellence and Evidence Guidelines to educational webinars and regular updates on compliance strategies.

CHAP Customer Relations Representatives (CRR) and Regional Directors of Professional Services (RDPS) are experienced and trained to provide expert guidance to customers on the CHAP Standards and the CoPs. Organizations contracted with CHAP should reach out to their CRR or RDPS by phone or email at any time with any questions about sustaining compliance.

For more information about the CMS sanctions, click here.

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