CY 2022 Home Health Final Rule – Survey and Enforcement Requirements for Hospices

To: NHPCO Provider and State Members
From: NHPCO Regulatory Team

Date: November 8, 2021

Summary at a Glance

On November 2, 2021, the Federal Register posted CMS-1747-F, the CY 2022 Home Health Prospective Payment System Rate Update Final Rule… Survey and Enforcement Requirements for Hospice Programs.

Important changes from the proposed to final rule:

1. Suspension of all or part of payments: NHPCO advocated for this provision to be limited to new admissions. In the final rule, CMS changed the language to read that the suspension of payments is for new admissions only.

2. Special Focus Program: NHPCO advocated for a Technical Expert Panel (TEP) to be convened to provide input prior to the development of any hospice Special Focus Program. In the final rule, CMS removed the regulatory language about the creation of the Special Focus Program and cited that revised language would be included in future rule making for FY 2024.

3. Surveyor conflict of interest: NHPCO advocated for ways that CMS could address surveyor conflict of interest. In the final rule, at 488.1110, CMS changed the language on surveyor conflict of interest to read: “surveyors must disclose actual or perceived conflicts of interest prior to participating in a hospice program survey and be provided the opportunity to recuse themselves as necessary.”

CMS has also issued the QSO-22-01-Hospice memo addressing the timeline for implementing the regulatory provisions of the CAA 2021 hospice provisions outlined in the CY 2022 HH final rule.