Menu

Announcement

New Patient Exclusion Criteria due to Individual State Laws
folder_openChanges to Protocols and Guidelinescalendar_todayPosted July 22, 2010

Some states have regulations or laws that govern the release of confidential and private health information for specific patient populations. For example, some states prohibit the release of health information to outside parties for individuals with HIV or AIDs or certain psychiatric conditions or diagnoses. Other states have regulations related to abused patients. Medicare-certified home health agencies administering the HHCAHPS Survey are responsible for making sure that the agency complies with all applicable state laws restricting the release of information for certain patient populations.

CMS and the Coordination Team are allowing Medicare-certified home health agencies that serve patients whose health information is regulated or restricted by state law to exclude these patients from the HHCAHPS-eligible patient population. Thus, agencies located in states that have laws or regulations restricting the release of health information for specific patients or those with certain types of health conditions should consider those patients to be ineligible for participation in the HHCAHPS Survey. The agency must ensure that it does not include any information about these patients on the monthly patient information files provided to the survey vendor.

The list of patients who are not eligible to participate in the HHCAHPS Survey will be revised to include patients for whom release of health information is restricted by state laws or regulations. For ease of reference, we will refer to these patients as “State Exclusions.” The revised list will be included in the HHCAHPS Protocols and Guidelines Manual, Version 3.0, which will be released in September 2010.

Medicare-certified home health agencies that served 59 or fewer patients who meet survey eligibility criteria between April 1, 2009 and March 31, 2010 may be exempt from participating in the Home Health Care CAHPS Survey. Any agency seeking an exemption from participating in the HHCAHPS Survey for the 2012 annual payment update should count the number of unduplicated patients they served between April 1, 2009 and March 31, 2010 and complete the Participation Exemption Request form which is available on the HHCAHPS Web site at https://homehealthcahps.org. Home health agencies in states that have laws or regulations restricting the release of patient information for specific patient populations should not include any of the patients protected by the state regulations or laws in the count of eligible patients.