While the government shutdown has suspended Medicare features that affect the home health industry, such as home health exemptions and telehealth flexibilities, some Medicare complaint investigations will continue.
The Centers for Medicare and Medicaid Services said in a revised memo Tuesday that investigating complaints alleging harm is considered essential work and will continue during the government shutdown. Certain federal enforcement actions arising from these investigations should continue to be imposed, and some revisit investigations may still be authorized.
“During an appropriation lapse, it is unlawful for CMS or a State (acting on behalf of CMS) to conduct federal investigation and certification activities beyond what is considered an ‘excepted activity,’” the memo states. “Exceptional activities are activities related to the safety of life or protection of property. When states perform non-exceptional functions under state government auspices, they should not represent federal investigation and certification activities.”
Recently completed investigations that did not identify any immediate danger or harm to patients or residents will be put on hold until the federal government provides funding. CMS said immediate threats to the life or safety of Medicare beneficiaries should still be addressed.
“We deeply regret the need to reduce the federal government's investigation and certification functions,” the memo said. “Of course, state licensing functions and state enforcement activities under state law are not constrained by a federal government shutdown.”
Some follow-up inspections are allowed to continue, including those necessary to ensure that any immediate danger or harm to patients has been addressed.
Standard recertification surveys funded by Medicare will not be conducted during the closure, including statutory surveys affecting home health agencies, with the exception of hospice surveys funded through the Consolidated Appropriations Act of 2021 (CAA).
CMS stated that no Minimum Data Set (MDS) or OASIS activities should be performed except those necessary to maintain provider reporting. No initial investigation or initial certification should be conducted.
Complaint investigations are the most difficult type of investigation for home health agencies and require comprehensive preparation steps, experts previously told Home Health Care News.
