New Medicare Rules For Homebound Patients

New Medicare Rules For Homebound Patients


Medicare patients typically receive home care services because it is difficult or impossible for them to leave their homes. But the Centers for Medicare and Medicare Services (CMS) has now implemented a new Medicare requirement that doctors must meet face-to-face with their patients who are receiving home health care in order for the patient's home health visits to be reimbursed.

Under the requirement, Medicare beneficiaries will have to see doctors 90 days before or 30 days after starting home health services. The move is aimed at reducing unnecessary Medicare home health care, which doubled to $19 billion from 2002 to 2009. The rule also applies to hospice patients, who by definition have been determined to have only six months to live. The face-to-face visit can be with a non-physician practitioner such as a nurse practitioner or a physician assistant, but a supervising doctor must sign the certification for the encounter.

Groups representing the home health and hospice industries say requiring face-to-face visits will create a severe hardship for some homebound frail seniors and patients who live in rural areas. Under the former law, doctors had to prescribe home health care for Medicare recipients to receive services, but they were not required to see the patients in person.

The face-to-face visit requirement, a part of the new health reform law, was to take effect January 1, 2011, and would have called for physicians to see patients within 30 days before or two weeks after the start of home care. But after complaints from providers, CMS delayed implementation for three months and expanded the timeframe for doctor visits.

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Marc Soss' practice focuses on estate and tax planning; probate and trust administration and litigation; guardianship law; and corporate law in Southwest Florida.  Marc is a frequent contributor to LISI and has published articles and been quoted in the Florida Bar, Rhode Island Bar, North Carolina Bar, Association of the United States Navy, Lawyers USA, Military.Com, Forbes.Com, and CNN Business. Marc also serves as an officer in the United States Naval Reserve.