CMS Revises SOM Manual for Consistency with the Program Integrity Regulations
September 11, 2015 03:25 PM
The Centers for Medicare & Medicaid Services (CMS) has revised section 2185 of the State Operations Manual (SOM) to specify when an existing HHA intends to move from its surveyed and certified location to a new site or location that is within the current approved geographic area, it notifies its Medicare Administrative Contractor (MAC) within 90 days of the move. Prior to the change, the SOM required home health agencies to notify their MAC within 30 days. The revision to the SOM is consistent with the Medicare’s provider enrollment regulations that require a 90 day notification for changes in location for HHAs.
When an existing HHA intends to move from its location to a new site or location that is within the current approved geographic area, the agency notifies its MAC within 90days of the move, and submits an amended 855A. The MAC reviews the information and makes a recommendation to the RO. The RO then makes the final decision to approve the change of location. If a decision can be made on the written application and supporting documentation, CMS may grant or deny an approval without requiring an onsite survey.
According section 2702 B of the SOM, changes of size or location do not ordinarily require a special survey. Only if the relocation raises significant questions as to the provider’s ability to maintain standards is a resurvey necessary. For example, a new location increases the distance between the parent HHA and its previously approved branch(es) to a point that it raises concern as to whether adequate supervision and control can be provided.
Click here to view the Change Request.