Home health, hospice patients need to have face-to-face encounter with physician: New Medicare rule

A new federal regulation issued by Medicare in November will create a crisis for approximately 4.5 million home health and hospice service patients. Starting on January 1, homebound elderly and disabled patients as well as hospice patients will now need to have a "face-to-face encounter" with a physician or nurse practitioner if they want to receive care under Medicare.  

The National Association for Home Care & Hospice (NAHC) understands the intent of the new rule is to maintain benefit integrity by ensuring strong physician involvement in care planning and authorization, however, is strongly encouraging Medicare to examine the implementation process. NAHC is calling for a transitional period of no less than six months after the rule is enacted, wherein Medicare can monitor for compliance, provide notice of noncompliance where appropriate, provide continuing education on the requirements, and institute changes in instructions and guidelines where needed.

"There may be valid reasons for this new regulation, but we anticipate major disruptions in access to hospice and home health care as most affected people, doctors included, have not even heard of the new rule yet," said Val J. Halamandaris, NAHC President.

Elderly and disabled Medicare beneficiaries who are confined to their homes for medical reasons or hospice patients in the midst of end of life care will need to find a way to either get to the doctor or get the doctor to come see them. This is the predicament that will result if considerations for home care and hospice needs are not made.

"Physicians' orders drive all health care services under Medicare, but face-to-face meetings should not be required to authorize home health care for patients who by definition must be homebound in order to qualify for services," said Halamandaris.

Ensuring the right to be cared for in our homes is America's last great civil rights battle.  The goal of NAHC is to help frail, disabled and dying Americans stay independent and happy in the comfort of their homes. Medicare should not jeopardize this with its overly hasty implementation of the "face-to-face" rule, without testing it first and without sufficient time for everyone involved to understand what is required of them.