Medicare Home Health PPS Rules for 2013

July 16 - Medicare Home Health PPS Rules for 2013 More detail on the proposed Medicare Home Health Rules for 2013. CMS continues to make changes to the required physician face-to-face encounter requirement. They have clarified that a non-physician practitioner (NPP) working in an acute or post-acute care facility can perform the face-to-face encounter if they communicate their findings to the acute or post-acute physician, who could communicate the findings to the patient's certifying physician. They have issued a clarification that a resident could perform a face-to-face encounter if they communicate the findings to the teaching physician. The teaching physician would communicate the findings to the patient's certifying physician. CMS continues to make changes and clarifications regarding therapy coverage and reassessment. The first proposal related to CMS penalties if a patient has more than one therapy and one of the disciplines misses a required measurement and assessment visit, only that discipline will be penalized for visits going beyond the 13th and 19th visit. The second proposal regards the penalty for missing a required measurement and assessment. The current rule for a patient who has one therapy discipline and does not receive the required measurement and assessment until visit until the 15th visit, visits 13, 14 and 15 would be non-covered. Under the proposed rule only visit 13 and 14 would be non-covered. The last item finalizes when the required measurement and assessments for the 13th and 19th therapy visit should occur if multiple therapy disciplines occur during the episode. The qualified therapist can perform the measurement and assessments between the 11th and 13th visit to meet the 13th visit requirement and between the 17th and the 19th to meet 19th visit requirement. This also applies to single discipline therapy episodes that are performed in rural areas. Listed below is the link for the proposed rule.  LINK