The Centers for Medicare & Medicaid Services works with State survey agencies to conduct survey and certification visits to assure compliance with quality standards and to be assured that Medicare or Medicaid certified providers are meeting statutory and regulatory requirements, conditions of participation or conditions for coverage.

The 2007 Continuing Appropriations Resolution (Pub. L. No. 110-5, H.J.Res.20, §20615(b)(2007)) directed the Department of Health and Human Services to charge user fees necessary for conducting revisit surveys on health care facilities cited for deficiencies during initial certification, recertification, or substantiated complaint surveys. The user fees only apply to the following Medicare–certified providers and suppliers: skilled nursing facilities/dually-certified nursing facilities, hospitals (including psychiatric hospitals and critical access hospitals), home health agencies, hospices, ambulatory surgical centers, rural health clinics and end stage renal disease facilities.   These user fees do not apply, at this time, to comprehensive outpatient rehabilitation facilities (CORFs), providers of outpatient physical therapy centers (OPTs), transplant centers or programs, religious nonmedical healthcare institutions (RNHCIs), Federally qualified health centers (FQHCs), community mental health centers (CMHCs), independent laboratories, physical therapists in independent practice, chiropractors, and portable x-ray centers.

Revisit surveys are performed when there are findings of deficiencies in patient care or processes that were identified in an earlier survey and are conducted to assure that the deficiencies have been corrected.  The primary purpose for the user fees is to provide for the continuation of CMS Survey and Certification quality assurance efforts to improve patient care and safety.  We also believe that these user fees will assure greater commitment to compliance for correcting identified quality of care problems.

The fees were effective on September 19, 2007 until the end of the 2007 federal fiscal year, which concludes on September 30, 2007.  CMS will use the current fee schedule until such time as a new fee schedule notice is proposed and published in final form.

Final Fee Schedule for Revisit Surveys (Onsite and Offsite)

Fees are based on the cost that CMS incurs as a result of the time and effort for State surveyors to conduct follow up as a result of deficiencies found.  Providers and suppliers have the right to reconsideration if they feel an error of fact has been made in the application of the user fee, such as clerical errors, billing for a fee already paid or assessment of a fee when there was no revisit scheduled.  A request for reconsideration must be received by CMS within 14 calendar days from the date identified on the revisit user fee assessment notice.

Providers who are assessed a revisit user fee will receive a notice in the mail which will include the amount of the assessed fee.  Payment must be received within 30 days or CMS could terminate the facility’s enrollment and participation in the Medicare program.  If you have additional questions, contact Carla.McGregor@cms.hhs.gov.