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Ask the expert: Is CMS’s State Operations Manual law?

Credentialing Resource Center Connection, February 19, 2009

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No, the Centers for Medicare & Medicaid Services’ (CMS) State Operations Manual (SOM) is not law, although it is widely followed in interpreting the meaning of CMS regulations. It provides direction to surveyors on how to conduct surveys, and surveyors will have it with them when they arrive, unannounced, to do a survey. As a practical matter, the SOM gives providers the clearest idea of how to comply with the Medicare Conditions of Participation (CoP), with one major problem—it is not regularly updated to address recent CoP changes. That means the SOM must be checked against the most recent CoP regulations to make certain the SOM is current. The SOM is can be found by going to the on the CMS Web site under “regulations and guidance,” then “manuals,” then “internet only manual.”

This week’s question and answer is from HCPro, Inc.’s 2008 Health Law Primer, by Kathy Kenyon, JD, CHC, with Robert A. Wade, Esq.

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