CMS has been working on implementing less severe punishments for agencies with state survey deficiencies that don’t warrant termination from the Medicare program – since 1987.

A new report by the HHS Office of Inspector General (OIG) now takes CMS to task for its lack of action on implementing intermediate sanctions such as fines, payment suspensions and appointment of temporary management following survey deficiencies.

The alternative sanctions could be appropriate for agencies whose deficiencies don’t directly endanger patients and for agencies that have had the same deficiencies on more than one consecutive survey, OIG says.

The latest chapter in the intermediate sanction saga: CMS has let OIG know that it’s working on a proposed rule that will outline a new set of sanctions. The federal Medicare agency plans to publish that rule by September.