The AHA again urged the Centers for Medicare & Medicaid Services yesterday to clarify how hospitals can share space, services and staff with other providers. “If CMS is unable to release the guidance by Oct. 1, we implore the agency to issue a Survey and Certification memo stating that while the guidance is in development, hospitals will not be required to dismantle sharing arrangements that are safe and provide important access to care,” wrote Ashley Thompson, AHA senior vice president for public policy analysis and development. AHA has asked the agency to clarify the issue since 2015, when a CMS presentation raised concern that long-standing co-location arrangements would suddenly be declared non-compliant with CMS rules. In March, CMS informed AHA that it was working to finalize updated guidance. “Out of an abundance of concern and in the absence of clear direction, some hospitals have begun to unwind their co-location or shared service arrangements,” AHA said. “Unfortunately, these changes can result in patients having difficulty accessing needed care…. A Survey & Certification memo could prevent hospitals from unwinding arrangements that ultimately may be allowed or creating sharing arrangements that in the end may be disallowed.”