Medicaid Adopts New Home Health Rules; F2F Requirement Delayed Until September 1

NH Medicaid adopted new Home Health Services Rules on July 1.  The He-W 553 rules include eligibility requirements, provider requirements, covered and non-covered services and documentation requirements.  The rules had been in the process of being revised since last fall and HCANH provided detailed written comments on multiple drafts.  There are two major changes which were required of all states by CMS:
  • Home health services may not be limited to the home.  Services can be provided in any non-institutional setting where normal life activities take place.
  • Patients must have a face-to-face encounter with a physician or authorized practitioner at least 90 days before or within 30 days after the start of care.  Physicians are expected to document the date of the encounter, practitioner’s name, and clinical reason for home health services and provide that documentation to home health agencies.
  • The F2F is required for the initial order for home health services for children and adults and for any episode that requires a Start of Care OASIS.
As in the past, Medicaid patients do NOT need to be homebound to receive home health services.  While the rules technically went into effect on July 1, HCANH requested a delay of enforcement of F2F requirement so that home health providers and physician practices could have more time to learn about and understand the requirement.  DHHS delayed the F2F requirement until September 1, 2016. DHHS was expected to issue Provider Bulletins this week on the new rules.
Questions?  Contact Gina Balkus