Proposed Sanctions Could Cost Non-Compliant Home Health Agencies $10,000 Daily

The Centers for Medicare & Medicaid Studies recently came out with a plan on impose intermediary sanctions on non-compliant home health agencies (HHAs) as the first set of options allowing an alternative to simply terminating the non-compliant companies. These sanctions could lead to new fines for the non-compliant agencies

Intermediary sanctions introduced include suspension of payment for new Medicare patients, temporary CMS-appointed management of the agency, guided correction plans, and civil monetary penalties (CMPs) ranging from $500 to $10,000. CMS proposes a specific range of monetary penalties based that varies with the seriousness of the deficiency. 

CMPs could be imposed on a “per day” or “per instance” basis and would not be allowed to exceed $10,000 per day of non-compliance. The amount of a CMP will be determined by a number of factors including the agency’s size, availability of additional HHAs in the region.

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Guided plans of correction would be imposed on HHAs to encourage agencies to correct their non-complaint practices with the guidance a CMS-developed plan. Agencies would work to establish goals to work toward in achieving their compliance. 

The newly proposed sanctions would be imposed on agencies based on, among other factors, the degree of non-compliance, the nature of the non-compliance, the number of repeat deficiencies, and whether the deficiency jeopardizes the agency’s ability to provide quality care, according to CMS. 

The newly imposed sanctions still include CMS’ ability to terminate an HHA if their practices pose immediate jeopardy to patients. 

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View the full proposal here

Written by Erin Hegarty