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HCA Takes Aim at Federal Regs, Seeks CoP Implementation Delay

HCA this week prepared and circulated two new federal advocacy pieces targeting a series of problematic home care regulations while calling for a one-year delay in implementation of the sweeping new Home Health Conditions of Participation (CoPs).

In a new document, entitled Home Care Advocacy Ask: Regulatory Relief for Home Care Providers, HCA targets five areas of regulation that demand change, consistent with our past advocacy efforts and support garnered from Members of New York’s Congressional Delegation.

Despite past bipartisan support on many of these issues, officials at the U.S. Centers for Medicare and Medicaid Service (CMS) and other government agencies have resisted calls for change. HCA is redoubling those efforts in 2017 as new appointments and policies are made within government agencies. Our position paper takes aim at: the Medicare face-to-face rule; the pre-claim review demonstration project; unfunded federal overtime mandates; limits on practitioners authorized to order and refer home care services; and the compressed timetable for implementation of the new federal CoPs.

For specific background details and advocacy recommendations on each of these issues/regulations, please download the report at

Digging deeper, the CoPs are also the subject of a separate document, entitled One-Year Delay Needed for Home Care Providers to Implement Biggest Changes to CoP Regulations in Nearly 30 Years. In this piece, HCA commends the intent of the CoP changes, but points out that the changes, though proposed two years ago, were swiftly finalized just this month with only six months for providers to prepare for them by a July 13, 2017 deadline. In addition, the structure of the system (emphasizing managed care and new integrated models) has moved on from that which existed when these revised CoPs were initiated years ago.

CMS has yet to even issue Interpretive Guidelines to educate state surveyors on the CoP changes and enforcement actions, putting further pressure on state health department surveillance units and providers to understand, implement and enforce over fifty new CoP amendments or additions – the biggest, one-time set of changes to the CoPs since 1989. HCA is seeking a one-year delay in implementation of the new CoPs until July of 2018.

To read more about our positioning and recommendations on the CoPs, please download the document here: