CMS Releases New Civil Money Penalty Analytic Tool

AHCA recently obtained an CMS Administrative Information Memo concerning a new process for calculating CMPs when it is determined they should be imposed.  The memo and accompanying instructions direct CMS Regional Offices to apply a new methodology and process for determining CMPs when such an enforcement remedy is appropriate.  The new policy guidance has been issued to promote more consistent application of enforcement remedies, and all CMS Regional Offices will use the guidance to choose, impose, and calculate CMPs.  CMS also included guidance for the Regional Office to consider when determining whether to impose a CMP or an alternate remedy regardless of whether or not the State Survey Agency recommended a CMP.

The memo states that failure of a State to recommend a CMP or other remedy, or a State policy of not recommending CMPs, are not acceptable reasons for not imposing such remedies.  In such a case, the RO must on its own review the survey findings and impose the appropriate remedy.
CMS describes this effort as a six-month pilot, to be evaluated for the usefulness and overall effectiveness of the Analytic Tool and guidance.  At the end of six months, they will assess whether or not the tool and guidance have provided greater consistency in the use and application of CMPs and assess whether or not the imposition of CMPs had an effect on a facility’s ability to achieve and sustain compliance with Federal requirements.  At that point, CMS will make any needed revisions to the tool and guidance as applicable.

The CMS Administrative Memo and Instructions are accessible in the Members Only section of the IHCA website.  IHCA also has a copy of an Excel spreadsheet that Regional Offices will use to calculate the dollar amount of CMPs and if you would like a copy, please contact Zach Cattell at zcattell@ihca.org.