BACKGROUND
The Centers for Medicare & Medicaid Services (“CMS”) published a final rule that added a new condition of participation for home health agencies (“HHA”) to participate in the Medicare program under the Medicare Program; Calendar Year (“CY”) 2025 Home Health Prospective Payment System (“HH PPS”).
NEW POLICY REQUIREMENTS
The new standard, §484.105(i), requires home health agencies (HHAs) to develop and maintain a policy for evaluating new patient referrals. The policy must address the HHA’s capacity to provide patient care, including the HHA’s caseload, staffing levels, and staff skills and competencies. CMS also requires the patient acceptance-to-service policy to be applied consistently to ensure that HHAs only accept the referral when there is a reasonable expectation that the HHA can adequately meet the referred patient’s needs.
Finally, HHAs must review the publicly facing information regarding their services provided and any service limitations to ensure this information is up-to-date and accurate. § 484.105(i)(2), requires HHAs to review the publicly facing information as frequently as services are changed, but no less often than annually.
CONSIDERATIONS FOR THE AGENCY
HHAs should review the Final Rule’s new requirement and develop the required acceptance-to-service policy. Each agency is responsible for developing an applicable policy to demonstrate compliance with §484.105(i) as of January 1, 2025. If you have any questions, would like assistance in preparing your agency acceptance-to-service policy or would like additional information about this topic, please contact MB Healthcare Consultants, LLC.