In The News

Denial Rates Rising Thanks to Home Health Cuts, Dombi, Cunningham Say 

McKnight’s Home Care
As the Centers for Medicare & Medicaid Services prepares to release its proposed home health rule for calendar year 2024, providers are holding out hope that CMS will omit any further rate cuts. In this McKnight’s Home Care Newsmakers podcast, National Association for Home Care & Hospice President William Dombi and Partnership for Quality Home Healthcare CEO Joanne Cunningham talked about their efforts to stop any reductions. They also discussed how the 3.925% permanent cut that went into effect in January has had significant effects on hospital-to-home-health conversation rates.

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It’s Mental Health Awareness Month

National Center for Complementary and Integrative Health

May is Mental Health Awareness Month, a good time to think about ways in which you can protect your mental health, including taking steps to manage stress.

Long-term stress can contribute to or worsen many mental and physical health problems. But fortunately, there are ways to counteract its effects. We have access to a built-in “stress reset button” that acts as an antidote to stress. It’s called the relaxation response. It’s the opposite of your body’s response to stress. The relaxation response slows your heart rate, lowers your blood pressure, and decreases oxygen consumption and levels of stress hormones.

By learning simple techniques that produce the relaxation response—such as progressive muscle relaxation, simple mindfulness exercises, and slow, deep breathing—you can help prevent stress from building up. That’s good for both your mind and your body.

Learn More About Stress


Surgeon General Outlines Framework to Address Loneliness

The Hill | By Lauren Sforza

Surgeon General Vivek Murthy, M.D., plans to introduce a three-part framework to address loneliness in the US, as about half of Americans are experiencing loneliness at any given time, and social disconnection can lead to an increased risk of mental health and physical issues in addition to premature death. Social connection must be a priority and "will require reorienting ourselves, our communities, and our institutions to prioritize human connection and healthy relationships," Dr. Murthy writes.

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Guidance for the Expiration of the COVID-19 Public Health Emergency (PHE)

Staff Vaccination Requirements

On November 5, 2021, the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) issued an interim final rule (CMS-3415-IFC) requiring Medicare and Medicaid-certified providers and suppliers to ensure that their staff were fully vaccinated for COVID-19 (i.e., obtain the primary vaccination series), which was a critical step to protect patients. On April 10, 2023, the President signed legislation that ended the COVID-19 national emergency. On May 11, 2023, the COVID-19 public health emergency is expected to expire. In light of these developments and comments received on the interim final rule, CMS will soon end the requirement that covered providers and suppliers establish policies and procedures for staff vaccination. CMS will share more details regarding ending this requirement at the anticipated end of the public health emergency. We continue to remind everyone that the strongest protection from COVID-19 is the vaccine. Therefore, CMS urges everyone to stay up to date with your COVID-19 vaccine.

Emergency Preparedness: Training and Testing Program Exemption

The following information supersedes the previously issued QSO-20-41-ALL-REVISED memo for all certified providers/suppliers. CMS regulations for Emergency Preparedness (EP) require the provider/supplier to conduct exercises to test their EP plan to ensure that it works and that staff are trained appropriately about their roles and the provider/supplier’s processes. During or after an actual emergency, the EP regulations allow for a one-year exemption from the requirement that the provider/supplier perform testing exercises. The exemption only applies to the next required full-scale exercise (not the exercise of choice), based on the 12-month exercise cycle. The cycle is determined by the provider/supplier (e.g., calendar, fiscal or another 12- month timeframe). The exemption only applies when a provider/supplier activates its emergency preparedness program for an emergency event.

See pages 10-12 of the attached document for updates on other home health and hospice-specific waivers.

Also see NAHC's "Ending of the COVID-19 PHE Waivers and Flexibilities" grid. 


Clarification on Technology for Hospices After the End of the PHE


CMS has answered the use of technology for hospices after the end of the public health emergency.  This answer was also shared in the National Stakeholder Office Hours on Ending the PHE on April 25, 2023.  Here is the transcript for that call, which shares the same information:  TranscriptOfficeHoursEndingPHE04252023 (

The regulatory flexibility at 42 CFR 418.204 is explicitly for the provision of routine home care services during the COVID-19 PHE. After the end of the COVID-19 PHE, the expectation is that routine home care hospice services will be provided in-person.  There is nothing precluding hospices from using technology to have follow-up communication with the patient and the family as long as the use of such technology does not replace an in-person visit. Additionally, such follow up contact should be documented in the hospice medical record similar to the way telephone calls would be documented and in accordance with the standards of practice and the hospice’s own policies and procedures. We cannot enumerate all of the scenarios in which there could be such contact via technology because each patient, family, and situation is different. Decisions about when such follow-up contact using technology is made need to be based on the needs of the patient and family and the hospice’s own policies and procedures. 

-CMS Hospice Policy

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