Home health and hospice industry officials welcomed a three-month CMS reprieve from the full enforcement of a new Medicare rule that kicked in on Jan. 1.
Face-to-face must wait
CMS delays enforcement of home health rule
The rule, implemented as a result of the Patient Protection and Affordable Care Act, requires that Medicare home health and hospice patients meet face-to-face with a physician—or a nurse practitioner collaborating with a doctor—before qualifying for Medicare coverage. The rule's intent is to ensure that care is provided based on a patient's current health situation, the CMS explained.
But after a concerted effort to delay implementation of the requirement, the CMS said last month that providers would not be required to document such a meeting until the beginning of the second quarter of this year. Nonetheless, the CMS said that face-to-face meetings should still take place in order to qualify for Medicare, according to an e-mailed statement from its news office.
Providers and others in home health raised concerns that implementation of the rule would result in patients not getting needed care. “There may be valid reasons for this new regulation, but we anticipate major disruptions in access to hospice and home health care as most affected people, doctors included, have not even heard of the new rule yet,” Val Halamandaris, president of the National Association for Home Care & Hospice, said in a news release days before the CMS agreed to delay the documentation requirement.
Peter Notarstefano, director of home and community-based services for the American Association of Homes and Services for the Aging, said his group supports the idea of increasing accountability of the program. But for many home health patients, merely getting to a doctor is a major financial or physical burden, he said. Groups that help with patient transportation, such as the area agencies on aging, may not be able to handle the rush of Medicare patients, he said.
Full implementation of the rule Jan. 1 would have resulted in disruptions to coverage and care for patients, and “nobody wants that,” he said. Notarstefano said the CMS was “terrific” in dealing with their concerns.
The added cost of requiring such a visit was not raised as an issue. At AccentCare, a home healthcare company in Irvine, Calif., the financial impact is expected to be minor. “There will be a modest cost with regards to training our clinicians and conducting in-services with physicians,” Vince Cook, executive vice president and chief financial officer, said in a statement. “However, there could be a financial impact if the physician does not want to comply with the new requirement, which would result in fewer referrals,” he said.
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.