CMS Proposes Revisions Regarding Documentation and Reassessment in Home Health Rule
In a home health proposed rule issued today, the Centers for Medicare and Medicaid Services (CMS) proposes additional regulatory flexibility regarding therapy documentation and reassessment as well as face-to-face encounter requirements. In addition, the rule would reduce Medicare payments to home health agencies in calendar year (CY) 2013 by 0.1%, or $20 million.
Proposed revisions regarding documentation and reassessment include:
- Revising the regulations to state that if a qualified therapist missed a reassessment visit, therapy coverage would resume with the visit during which the qualified therapist completed the late reassessment. This would be a change from the current policy that does not allow payment for the late reassessment visit.
- Amending the regulations to state that in cases where multiple therapy disciplines are involved, if the required reassessment visit was missed by any 1 of the therapy disciplines, therapy coverage would cease only for that particular therapy discipline. Under current policy therapy coverage would cease for all disciplines until reassessments are completed by all therapy disciplines involved in care.
- Modifying the regulations to clarify that in cases where the patient is receiving more than 1 type of therapy, qualified therapists could complete their reassessment visits during the 11th, 12th, or 13th visit for the required 13th visit reassessment and the 17th, 18th, or 19th visit for the required 19th visit reassessment.
CMS proposed to change the regulations to allow a nonphysician practitioner in an acute or post-acute facility to perform the face-to-face encounter in collaboration with or under supervision of the physician who has privileges and cared for the patient in the acute or post-acute facility. This will inform the decision regarding the patient’s homebound status and need for skilled services.
In addition, this proposed rule includes provisions regarding quality reporting for hospice and provides updates to the home health quality reporting program. This rule also would establish requirements for unannounced, standard, and extended surveys of home health agencies (HHAs) and provide alternative sanctions if HHAs are out of compliance with federal regulations.
APTA will provide members with a thorough analysis of the proposed rule shortly. The association will submit comments to CMS by the September 4deadline. A final rule will be issued on or around November 1 and provisions will become effective in 2013.