Provider Letter 17-35 DADS released the latest Provider Letter 17-35 – Determination of Separate Entities which replaces PL 01-46 & PL 02-05 for Medicare Certified Home and Community Support Service Agencies. The letter details that the Centers for Medicare and Medicaid Services (CMS) requires that Medicare-certified home health agencies (HHAs) meet the Medicare Conditions of Participation (CoPs) for all clients being served by the agency, regardless of a client’s payment source. The Medicare CoPs apply to all clients served by a certified HCSSA, including those receiving only personal care services.
DADs details How to Establish a Separate Entity: The Centers for Medicaid & Medicare Services (CMS) does not define “separate entity;” however, the State Operations Manual (SOM), Section 2183, outlines criteria to help surveyors differentiate a separate line of business. When a HCSSA alleges a separate entity and that the Medicare CoPs do not apply to that entity, the HCCSA must produce evidence in the following categories: operation of the HCSSA; consumer awareness; and, staff awareness.
If you need further information regarding separate entities refer to the provider letter and details within. Provider Letter 17-35