The U.S. Centers for Medicare & Medicaid Services (CMS) has clarified its position on survey and credentialing activities during the government shutdown.
In a Tuesday memo, the agency effectively limited survey work during the federal shutdown to essential health and safety functions.
For ambulatory surgery centers (ASCs), only complaint investigations classified as immediate jeopardy (IJ)and those involving actual harm may proceed, along with revisits approved by exception and necessary to prevent termination.
State-funded licensure surveys may continue, but they should not be assumed to count as federal surveys.
“During a lapse in appropriation, it is not legal for CMS or States (acting on CMS’ behalf) to carry out federal survey and certification activities beyond those deemed to be ‘excepted activities,’” the memo reads. “Excepted activities are those related to the safety of human life or protection of property. If States carry out non-excepted functions under the auspices of the State Government, they should not represent these as Federal Survey and Certification activities.”
Medicare-funded recertification surveys and routine Medicare provider certification activities, such as initial certifications, changes of ownership and changes of location, are suspended, as is the processing of recently completed surveys, according to Brian Williams, vice president of compliance at MedTrainer.
State survey agencies may request approval to conduct a revisit when a provider has claimed compliance with CMS requirements, and the revisit survey is necessary to determine compliance or to prevent scheduled Medicare termination of a provider or supplier, or to avoid a statutorily mandated denial of payment for new admissions, the memo explained.
Katie Pierson, regulatory specialist at Ambulatory Healthcare Strategies, said that accredited centers can still undergo their regular deeming surveys through the Accreditation Association for Ambulatory Health Care, The Joint Commission, QUAD A or the Accreditation Commission for Health Care since those are privately funded.
Still, CMS can’t finalize Medicare certification actions tied to them until appropriations are restored.
“In practice, this may delay start-ups or ownership changes but doesn’t appear to alter day-to-day compliance expectations,” Pierson told ASC News. “The key for ASC leaders is to stay survey-ready and patient-focused. The regulatory bar hasn’t moved; the federal processing timeline has.”
Broadly, compliance experts and ASC industry insiders told ASC News that the stance shouldn’t impact day-to-daily operations.
More than anything, it’s just another example of how the shutdown can lead to new questions and uncertainty for organizations operating in the Medicare and Medicaid spaces.
