42 USC 1395i-6 - Hospice program survey and enforcement procedures

U.S Code last checked for updates: Apr 26, 2024

§ 1395i–6.

Hospice program survey and enforcement procedures

(a)

Surveys

(1)

Frequency

(2)

Public transparency of survey and certification information

(A)

Submission of information to the Secretary

(i)

In general

(ii)

Required inclusion of specified form

(B)

Public disclosure of information

(3)

Consistency of surveys

(4)

Survey teams

(A)

In general

(B)

Prohibition of conflicts of interest

(C)

Training

(5)

Funding

(b)

Special focus program

(1)

In general

(2)

Periodic surveys

(c)

Enforcement

(1)

Situations involving immediate jeopardy

(2)

Situations not involving immediate jeopardy

(3)

Penalty for previous noncompliance

(4)

Option to continue payments for noncompliant hospice programs

The Secretary may continue payments under this subchapter with respect to a hospice program not in compliance with the requirements specified in section 1395x(dd) of this title over a period of not longer than 6 months, if—

(A)

the State or local survey agency finds that it is more appropriate to take alternative action to assure compliance of the program with such requirements than to terminate the certification of the program;

(B)

the program has submitted a plan and timetable for corrective action to the Secretary for approval and the Secretary approves the plan of corrective action; and

(C)

the program agrees to repay to the Federal Government payments received under this subchapter during such period if the corrective action is not taken in accordance with the approved plan and timetable.

The Secretary shall establish guidelines for approval of corrective actions requested by hospice programs under this paragraph.

(5)

Remedies

(A)

Development

(i)

In general

Not later than October 1, 2022, the Secretary shall develop and implement—

(I)

a range of remedies to apply to hospice programs under the conditions described in paragraphs (1) through (4); and

(II)

appropriate procedures for appealing determinations relating to the imposition of such remedies.

Remedies developed pursuant to the preceding sentence shall include the remedies specified in subparagraph (B).

(ii)

Conditions of imposition of remedies

(B)

Specified remedies

The remedies specified in this subparagraph are the following:

(i)

Civil money penalties in an amount not to exceed $10,000 for each day of noncompliance by a hospice program with the requirements specified in section 1395x(dd) of this title.

(ii)

Suspension of all or part of the payments to which a hospice program would otherwise be entitled under this subchapter with respect to items and services furnished by a hospice program on or after the date on which the Secretary determines that remedies should be imposed pursuant to paragraphs (1) and (2).

(iii)

The appointment of temporary management to oversee the operation of the hospice program and to protect and assure the health and safety of the individuals under the care of the program while improvements are made in order to bring the program into compliance with all such requirements.

(C)

Procedures

(i)

Civil money penalties

(I)

In general

(II)

Retention of amounts for hospice program improvements

(ii)

Suspension of payment

(iii)

Temporary management

(D)

Relationship to other remedies

(Aug. 14, 1935, ch. 531, title XVIII, § 1822, as added Pub. L. 116–260, div. CC, title IV, § 407(a)(1), Dec. 27, 2020, 134 Stat. 3003.)

cite as: 42 USC 1395i-6