The new regulations, introduced by the Patient Protection and Affordable Care Act, require a physician or non-physician practitioner working with the physician to authorize home health services in a face-to-face encounter occurring 90 days prior to or within 30 days after the start date of care. Similarly, a physician or nurse practitioner must to have a face-to-face encounter with a hospice patient prior to the patient’s 180th-day re-certification, and each subsequent re-certification. The encounter must occur no more than 30 calendar days prior to the start of the hospice patient’s third benefit period.
Medicare home and hospice care without these authorizations will not be reimbursed.
CMS pushed back its originally planned start date to April 1. However, the AHA had asked for the start date to be delayed until July to give providers more time to prepare for compliance, according to the report.
Read the AHA News Now report on home health authorization.
Read CMS’ notice on home health authorization (pdf).
Read more coverage on home health:
– 3 Ways Hospitals Can Adapt to New Requirements for Home Health Referrals
