VNAA: Clock is Ticking on Home Health CoP Rule Guidance

The Visiting Nurse Associations of America (VNAA) is not yet calling for the new home health Conditions of Participation (CoP) rule to be delayed, but it would like to see interpretive guidance for the massive regulation within 30 days.*

The home health provider association is sending a letter to CMS this week to push for the guidance on this timeframe, VNAA Vice President of Policy and Innovation Joy Cameron told Home Health Care News.

“It’s a necessary tool and we’d really like to see it,” Cameron said. “We need the clarification not just for us, but for state surveyors and certifiers.”


CMS has not been clear on when the guidance will come, and did not shed light on the matter during an Open Door Forum call with providers on Wednesday, she noted.

The CoP regulation sets the requirements that home health agencies must meet to participate in the Medicare and Medicaid programs. The voluminous rule includes several new requirements for agencies, including that they all have a quality assurance and performance improvement (QAPI) program in place. Its initial implementation cost is estimated at $30,000 per agency.

A Trump Delay?


VNAA is concerned that “there may be some belief” that the interpretive guidance should be held up under President Donald Trump’s Jan. 24 executive order, which instituted a regulatory freeze, Cameron said.

However, interpretive guidance does not promulgate any new policies, but just explains relevant statutes and regulations so that they can be applied and people know what they need to do for compliance, she noted.

There should be “room for this work [on the guidance] to continue,” she said.

As for whether the CoP regulation itself could be under reconsideration per Trump’s Jan. 24 order or one that followed on Jan. 30, Cameron emphasized that it was vetted for a long time before CMS issued the final rule in January.

“It was at OMB [Office of Management and Budget] for, what, almost two years?” she said. “There doesn’t seem to be the need for additional delay.”

On this, VNAA has struck a different note than another prominent home health association, the National Association for Home Care & Hospice (NAHC). Earlier this week, NAHC urged CMS to either push back the implementation date for the regulation or consider rescinding it entirely.

While VNAA is not yet echoing this position, it’s not out of the question in the future, Cameron said.

“At this time, we’re not asking for an extension on the CoP [implementation date],” she said. “We’ll revisit that, if we can’t get the interpretive guidance.”

*Editor’s Note: This article has been corrected from an earlier version, which stated that VNAA was requesting interpretive guidance within 60 days.

Written by Tim Mullaney

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