CMS Extends Time to Finalize Discharge Planning Proposal

By AJ Plunkett

If you were expecting to implement the latest discharge planning revisions to the Medicare Conditions of Participation soon, you can breathe a little easier for now. CMS took the unusual step on October 30 of announcing a year’s time extension to publish the final rule. The extension runs through November 3, 2019.

By federal regulation, such rules must be finalized and published with three years of proposal “except under exceptional circumstances.” In announcing the time extension for the final rule, which could have significant impact on hospitals and home health agencies, CMS noted that it received 229 comments after it first proposed the rule November 3, 2015.

“In this case, the complexity of the rule and scope of public comments warrants the extension of the timeline for publication,” according to the Federal Register notice published online October 30.

The rule, “Medicare and Medicaid Program; Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies,” has been under review by CMS’ legal team since at least April, according to consultants and other officials.

CMS wants to coordinate with IT

CMS indicated that part of the delay was in order to collaborate with HHS’ Office of the National Coordinator for Health Information Technology.

Among other things, CMS is proposing to “implement the discharge planning requirements of the Improving Medicare Post-Acute Care Transformation Act of 2014 (Pub. L. 113-185), that requires hospitals, including, but not limited to, short-term acute care hospitals, CAHs and certain post-acute care (PAC) providers, including long term care hospitals, inpatient rehabilitation facilities, HHAs, and skilled nursing facilities, to take into account quality measures and resource use measures to assist patients and their families during the discharge planning process in order to encourage patients and their families to become active participants in the planning of their transition to the PAC setting (or between PAC settings),” according to the extension announcement.

Based on information received from the public and other stakeholders, CMS says it needs more time to evaluate the impact of the proposed rule.

“The commenters presented procedural and cost information related to their specific circumstances, and the information presented requires additional analysis,” says CMS, adding that “we have determined that there are significant policy issues that need to be resolved in order to address all of the issues raised by public comments to the proposed rule and to ensure appropriate coordination with other government agencies.”