Tag Archives | face to face

New material from CMS offers clarity on Face to Face

In the early days of CMS’ new nationwide home health “Probe and Educate” review, nearly 90% of claims have been denied – with MAC NGS denying 97% of all claims reviewed! It’s clear that issues remain with face-to-face (F2F) documentation despite recent regulatory changes. For a few years the Affordable Care Act has required a […]

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Update on Face to Face

On November 6, 2014, The Centers for Medicare & Medicaid Services (CMS) issued final rule CMS-1611-F, Calendar Year (CY) 2015 Home Health Prospective Payment System (HH PPS) Final Rule.  The HH PPS final rule (79 FR 66032) finalized a change that, beginning, January 1, 2015, requires home health agencies (HHA) to obtain documentation from the […]

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Congress Issues Report to CMS Asking it to Justify its Face-to-Face Policy

As part of its analysis of the ongoing face-to-face issue, Inside Health Policy recently summed up the continuing frustration the home care and hospice community feel surrounding the face-to-face requirement: “[The Home Care] Industry has viewed the Affordable Care Act’s face-to-face requirements as flawed and unclear. As part of the face-to-face documentation, a physician narrative […]

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Congressional Budget Calls for CMS Report on F2F, Rebasing

The $1.1 trillion spending plan approved by the Congress includes ‘report language’ on the Medicare Home Health face-to-face (F2F) rule and Medicare home health rebasing. While ‘report language’ is non-binding, it nevertheless could have policy implications if implemented by the Centers for Medicare and Medicaid Services (CMS). Below is the language contained in the bill: […]

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CMS Urged to Delay F2F Enforcement

Last week the Home Care Association of New Hampshire joined state home care associations across the nation to urge CMS to delay enforcement of the new Medicare Face to Face certifying requirements for physicians.  The letter sent to Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner urged a phased-in approach to the new […]

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New England Senators Send F2F Concerns to CMS

A bi-partisan Senate letter raising questions and concerns about Medicare medical reviews and F2F denials was sent to CMS Administrator Marilyn Tavenner last week.  The letter was initiated by Senator Kelly Ayotte and co-signed by Senator Jeanne Shaheen, along with seven other Senators from Vermont, Maine, Massachusetts and Connecticut. “Home health agencies in our states are being overwhelmed […]

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CMS Announces Update for Home Care Condition of Participation

Administration focuses on post-acute care for data collection and improvement The Centers for Medicare & Medicaid Services (CMS) announced Monday an initiative aimed at nursing homes and home care settings. According to CMS, the proposed changes would improve the quality of home health services for Medicare and Medicaid beneficiaries by strengthening patient rights and improving […]

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CMS Issues Final Rule for 2015

Late Thursday CMS released its final rule for 2015 Medicare Home Health PPS rates. CMS also finalized some of the other proposals – including eliminating the physician narrative to the face-to-face requirements. Below are some highlights of the Final Rule: The physician F2F narrative requirement has been eliminated effective January 1, 2015. The F2F encounter […]

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NAHC Lawsuit on Face-to-Face Physician Encounter Rule Advances

According to today’s NAHC Reports, the lawsuit challenging the face-to-face rule is advancing in Federal District Court. The Department of Justice has filed a motion to dismiss with the court arguing that the court does not have the power to hear the case. The Medicare Motion to Dismiss argues that NAHC failed to exhaust all […]

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