New Executive Order Could Relax Some Home Health Regulations

Tuesday, April 11, 2017






As any business owner can attest, the regulatory environment in the U.S. is, at minimum, riddled with complexity. Not only is it often challenging to comply with federal, state, local, and industry regulations, but it can be costly as well. The home health care industry alone spends millions of dollars on this effort every year, but relief from regulatory burdens may be on the horizon.


On Jan 30, President Donald Trump signed an executive order requiring that two regulations be cut for every new regulation that is enacted. While the order will effectively reduce the burden of regulatory compliance on American businesses, the primary aim is cost cutting. Under the provisions of the order, the total incremental cost of new regulations is to be zero, and the costs associated with any new rule must be offset by eliminating two other rules.


That being said, the home health care industry is optimistic that this new order could mean the end of certain cumbersome regulations that industry groups claim are harmful to their businesses and the delivery of quality patient care.


Regulations on the Chopping Block

In the weeks since the executive order was signed, home health industry groups, including the NAHC and the Visiting Nurses Association of America (VNAA) have already identified regulations that they would like to see scaled back or eliminated. Among the most high-profile regulations potentially on the chopping block are the Pre-Claim Review Demonstration (PCRD) and the new Conditions of Participation for Medicare set to take effect in July.


The PCRD is already controversial and under scrutiny; the start date for the project in Florida was pushed back to April 2017 after early results from Illinois indicated serious problems with the process. Given that the author of legislation to pause the PCRD, Representative Tom Price of Georgia, has been named the Secretary of the Department of Health and Human Services, and has been very supportive of efforts to reduce regulations in home health, many are optimistic that the PCRD will be put on hold, at least temporarily, or undergo significant changes.


The other major regulation that is set to take effect is the Conditions of Participation, and Trump’s executive order could put the start date of those regulations into question. The new administration has ordered a review period for all new regulations, and given the substantial overhaul of the CoP, there may still be time for changes. This would be welcome news to many, who are concerned about the short time frame for the implementation of the new regulations. However, as of right now, nothing has changed, and agencies are still going to be held to the new rules.


Among the other regulations that home health industry groups are looking to revise include the face-to-face requirement, some of the more cumbersome documentation requirements, and the prohibition against nurse practitioners signing off on orders for home health services. The VNAA and NAHC have been lobbying for these changes through legislation, but President Trump’s executive order opens the possibility of making changes via a regulatory path. Like the other regulations, though, these rules are still in effect, and agencies must continue to comply with them. Tools that make compliance easier, including advanced software, will continue to be useful even if and when the rules change.


Cautious Optimism

While there is potential for the new one-in, two-out rule to reduce regulatory burdens across the board, most industry leaders say that they are only cautiously optimistic that it will amount to any measurable change. While it is impossible to say how the new order will actually effect the operation of home health agencies, there are some who suspect that this order won’t actually do much to ease the regulatory environment at all. That’s because the order, with its focus on cost reductions and offsets, doesn’t differ significantly from orders that are already in place from previous administrations.


Still, home health officials remain optimistic even if the order doesn’t have the bite that it could. The fact that the new administration is focused on improving the regulatory environment and reducing some of the more cumbersome aspects of health care delivery has many closely watching what is happening in Washington. According to the NAHC, orders like this one are creating new opportunities for the home health industry to work closely with lawmakers and regulators to create a better environment for delivering quality, cost-effective care.


To stay abreast of developments in Washington that will affect your agency, keep following the Complia Health blog for updates. And to learn more about the advanced home health software products that you help you manage your agency and remain in compliance with all rules and regulations, click here to check out our comprehensive family of products.