Waiver of State Regulations Now Allow Care Plan Requirements in Federally-Certified Agencies to Be Met by Nurse Practitioners or Physician Assistants

To: Class A Homecare Agencies From: Cheryl McMahon In response to the Centers for Medicare and Medicaid Services (CMS) bulletin "Home Health Agencies: CMS Flexibilities to Fight COVID-19" (https://www.cms.gov/files/document/covid-home-health-agencies.pdf ), the Division received a question about the state regulations in 6 CCR 1011-1, Chapter 26, Home Care Agencies, that prevent federally certified agencies from having care plans established or periodically reviewed by a nurse practitioner or physician assistant. Acknowledging the enforcement discretion CMS is using, the following regulation is waived for all Home Care Agencies as follows, with no waiver application necessary:   6 CCR 1011-1, Chapter 26, Part 7.10(A). Care follows a written plan of care established and periodically reviewed by a doctor of medicine, osteopathy, or podiatric medicine. Care plans established by a nurse practitioner, physician assistant or other therapists within their scope of practice may be accepted by an HCA that is not federally certified as a home care agency. For PACE participants, the interdisciplinary team shall establish, follow and periodically review the plan of care. The portion of this rule that prevents federally certified agencies from having nurse practitioners or physician assistants establish or periodically review care plans is waived. Agencies must continue to meet the requirements for the establishment and periodic review of a written plan of care. The waiver will remain in place as long as CMS is exercising enforcement discretion. For questions or assistance, contact Cheryl McMahon (cheryl.mcmahon@state.co.us). Cheryl McMahon Branch Chief Home and Community Facilities Branch Chief