Update on Legislative Efforts to Reform the Home Health Face-to-Face Documentation Requirement
October 8, 2015 11:10 AM
The National Association for Home Care & Hospice (NAHC) continues its efforts to advance legislation in the United States Congress to reform the Medicare home health face-to-face documentation requirement. Champions in both the U.S. House and Senate are pursuing bicameral, bipartisan legislation that reforms the face-to-face documentation requirement so as to address the burdensome paperwork requirements and the problems that have resulted for Medicare providers and beneficiaries. Most recently, Congress Greg Walden (R-OR) announced draft legislation, which was the subject of a hearing before the Energy & Commerce Committee on October 1 (see previous NAHC Report article here), and earlier this year, Senators Robert Menendez (D-NJ) and Pat Roberts (R-KS) introduced legislation, on which they continue working to modify and improve (see previous NAHC Report article here).
In support of advancing a legislative remedy in Congress, NAHC continues to work with Congressman Walden and Senators Menendez and Roberts to refine their bills so that the bills adequately address the paperwork burdens and the problems that have resulted, including wrongfully denied claims. The lawmakers intend to coordinate their legislative efforts in order to ensure they are bicameral, as well as bipartisan. The Senate bill already has bipartisan cosponsors in Senators Menendez and Roberts, and Congressman Walden has reached out to several colleagues on the House Energy & Commerce and Ways and Means Committees to enlist bipartisan original cosponsors.
NAHC has stated that full-scale reform should:
Limit the physician documentation requirement to demonstrating that a timely encounter occurred, consistent with the original intent;
Narrow the circumstances where a face-to-face encounter is required by excluding patients transferred from a hospital or skilled nursing facility where physician encounters are virtually guaranteed;
Address the thousands of past claim denials by requiring the Centers for Medicare & Medicaid Services to either reach a settlement with affected home health agencies or reopen and pay those claims denied related to the physician narrative;
Provide an exception in areas where physicians are scarce;
Permit a waiver in a case-specific situation where a face-to-face encounter is not feasible; and
Permit face-to-face encounters by way of an expanded telehealth definition as the standard in the current law is useless as a patient must leave her home to have a telehealth visit with a physician.
Once the F2F reform is submitted as a bill, NAHC will issue a member alert, calling on all to help gain as many cosponsors as possible. That effort will hopefully lead to the inclusion of the bill on a “must pass” measure. We will need quick action and a high rate of success in gaining cosponsors in order to achieve that goal before the end of the year.
In addition to seeking a legislative remedy, NAHC continues its legal challenge to the claim denials resulting from the Medicare home health services physician face-to-face narrative requirement. A decision on its lawsuit challenging the validity of the physician narrative requirement is likely any day from the federal court in Washington. You can read more about NAHC’s lawsuit here.