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CMS Issues Proposed Rule That Would Change Home Health Face-to-face Requirements

On Friday, July 13, 2012 the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that if finalized would change the face-to-face requirements of a home health encounter. Under the current rule, before certifying a patient’s eligibility for the home health benefit the physician must document a face-to-face encounter with the patient. In lieu of the physician having a face-to-face encounter, an allowed non-physician practitioner (NPP) may have the face-to-face encounter with the patient and notify the certifying physician. Allowed NPPs under the current rule are nurse practitioners, clinical nurse specialists, certified nurse-midwives, and physician assistants.

Under the current rule, a physician who cared for a patient in an acute or post-acute care facility, and had privileges at that facility, could perform the face-to-face encounter and inform the certifying physician. The proposed rule would allow a NPP working in collaboration with a physician in an acute or post-acute care facility to perform the face-to-face encounter, report it to the acute care physician, who would then report it to the certifying physician. The proposed rule is intended to provide the certifying physician with the most accurate and timely assessment of the patient’s current clinical condition.

If you have any questions about the current or proposed rule, or need help implementing a compliance plan for your home health agency, please contact an experienced Wachler & Associates healthcare attorney at 248-544-0888.