Turns out it’s not just health care providers that notice CMS’s foot-dragging. Last Thursday the Office of Inspector General (OIG) of Health & Human Services (HHS) published its report on what CMS has done—or rather, has not done—in response to a Congressional mandate issued in 1997.

The mandate concerns the Rural Health Clinic (RHC) designation created in 1977 entitling a facility to enhanced Medicare and Medicaid funding if it’s located in an area that’s (a) rural and (b) has a shortage of providers. By 1997 Congress had figured out that some facilities that originally qualified no longer met both criteria. So in the Balanced Budget Act of 1997 Congress ordered CMS to issue regulations that would take away the RHC status from any facility that no longer met the location requirements unless it was determined to be an “essential provider.”

Eight years later, in 2005, the OIG did a study and determined that (a) about 300 RHCs no longer met the criteria and (b) CMS hadn’t gotten around to issuing any regulations.

Fast forward another nine years (on top of the eight that passed before last study), and the OIG did another study.  This time (a) 434 no longer qualify and (b)—you guessed it—CMS still hasn’t issued final regulations.  What’s more, the CMS staff responsible for the matter says that they don’t have any “current plans” for issuing regulations.

CMS’s formal response to the study, in its entirety, reads as follows:  “The CMS thanks OIG for their efforts on this issue.”

Your tax dollars at work.