Several proposed changes to the United States Centers for Medicare & Medicaid Services hospice survey process could result in tougher enforcement and stiffer penalties in 2022 for hospices. Regulators announced the proposed changes in June of 2021.
What is the potential impact on hospices in 2022?
Proposed changes that could affect hospices
Nine proposed changes could affect hospice providers. The proposed rule establishes a Special Focus Program that can penalize hospices if accreditation or CMS surveys expose a serious history of deficiencies. The SFPs will be able to impose fines, appoint temporary management to get a hospice back in compliance, suspend reimbursement and revoke the Medicare certification of non-compliant providers. Additionally, the results of accreditation surveys, which historically have been confidential, will be publicly disclosed. It is also likely that regulators will conduct a greater number of surveys.
Reason for the changes
Reports filed in 2012 and 2016 alleged that 20% of hospices surveyed by regulators or accreditors had deficiencies that posed serious safety risks. Advocates for the industry believe that regulatory reform should focus only on hospices with a history of non-compliance rather than the industry as a whole. However, proponents of the proposed changes believe that the new enforcement rules accomplish that objective already.
The proposed penalties, such as revoking Medicare certification, could have a major impact on the industry and even cause the closure of non-compliant hospices. The hospice industry is preparing for the potential changes by reviewing recent surveys for compliance issues and addressing those issues before the changes go into effect.