Home Health Rulemaking Process: How to Affect CMS Policies

Rule Making for HH

How to Comment on the Home Health Proposed Rule

The rulemaking process is what occurs to finalize a Proposed Rule. For Medicare, CMS is the agency that proposes a rule and a rule can contain many new regulations. CMS puts the rule out via the Federal Register so that it can be reviewed by all stakeholders and interested parties. The process also allows stakeholders and interested parties to provide feedback. Unfortunately, participation in the process by the stakeholders and interested parties has been very scant over the years.

Guest blogger John Reisinger, CPA and Principal of Innovative Financial Solutions for Home Health offers an in-depth summary on how you can (and should) participate in the rulemaking process by submitting your comments to CMS.

Let’s dive in.

The RuleMaking Process

When rebasing was proposed back in 2014 (the biggest proposed change since the inception of PPS at that time), there were only 100 comments submitted. This was at a time when there were well over 12,000 home health agencies, plus other interest parties like associations, vendors, consultants, attorneys, etc. that primarily call home health their work focus. Commenting on significant proposed changes is one of the most beneficial advocacy activities you can do for yourself and this industry.

Do your associations, vendors, EHRs, consultants, attorneys, leadership team, etc. submit comments on proposed rules?

If yes, they truly advocate for this industry. Be sure to thank them! If not, you might ask them why not, especially if they consider themselves industry advocates.

Making Meaningful Impacts

Participating in the commenting process is the best way to influence how regulations outlined in proposed rules are implemented under the final rule and when. Providing meaningful commenting is twofold:

  1. Submitting High-quality comments (not cut-and-paste as has been recommended by too many), and
  2. Increasing the volume of comments submitted, but again, not via cut-and-paste (cut-and-paste comments detract from the value of the original comment).

These proposed changes impact your livelihood, so it’s worthwhile to get involved and submit comments. You can pick and choose what topic(s) you want to comment on and you can even do it anonymously. Every year, there are a few topics worthy of comment. And in some years, like when PDGM was introduced, there’s a multitude of topics to comment on.

How to Submit Comments to CMS

The easiest way to submit comments is electronically. Here are the steps:

  1. Go to https://www.regulations.gov/.
  2. Search for the keyword ”home health proposed rule.”
  3. Check the box, “Only show documents open for comment.”
  4. Select the box for “Centers for Medicare & Medicaid Services” on the left under Agency.
  5. Find the current proposed rule and click “Comment.”
  6. Type in your comment or upload a document with your comments. Entering in an email is optional.
  7. You can choose to submit the comments as an individual, organization, or anonymously.
  8. A tracking number will appear on the confirmation page.

When to Take Action

The rulemaking process is available to us whenever CMS proposes any type of regulatory and/or reimbursement changes that are considered materially significant to our industry. CMS will give a timeline to submit your comments for them to be considered by CMS in the development of the final rule.

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