CMS meets with coalition to hear arguments for delaying face-to-face enforcement

This update is provided by NAHC. It is a report on the March 18 meeting with CMS on Face-to-Face Encounter Requirements.

A meeting was held with the Centers for Medicare & Medicaid Services (CMS) last Friday to present and discuss a request to further extend postponement of the home health face-to-face encounter requirements’ enforcement.

Included among the coalition advocating for the delay were:  AARP, the American Medical Association, NAHC, and a wide assortment of physician groups. The American Hospital Association and Catholic Health Association of the United States both have conveyed their support of the extended enforcement delay request.
The purpose of the extension would be to continue and expand physician education efforts regarding the face-to-face encounter requirements and finalize standards for compliance for physician documentation and other issues. One proposal discussed was to allow home health agencies (HHAs) to use the former CMS Form 485 as sufficient documentation.
Jonathan Blum, director of the Center for Medicare, expressed concern at the meeting about an additional extension. Specifically, Blum questioned whether physicians would be more ready in July than they are today and whether the best way to bring about compliance isn’t simply to put the requirements into effect.
Responded to these concerns, the physician groups noted that past experience indicates that a period of six months normally is needed to get the message to “filter through” to physicians in the field, no matter how hard parties try to speed up the process. Beneficiary advocates expressed their concerns that patients may be denied admission to care or may be subject to discharge if the face-to-face encounter and documentation are not completed within 30 days.

Blum reminded attendees of the meeting that the final rule setting forth the face-to-face requirements is based on the health care reform law Congress passed, and that there is little flexibility for CMS in the matter.

Blum promised to respond to the suspension request early this week, given that the enforcement date is currently April 1.
Assessment
The odds favor CMS granting the further extension of suspension of the rule’s enforcement. The unprecedented coalition of parties presented a persuasive case for the extension on the merits of doing so.

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