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Advocacy Groups Pushing to Delay Face-to-Face Rule

Section 6407 of the Patient Protection and Affordable Care Act requires a face-to-face encounter for home health and hospice patients to qualify for Medicare coverage. On March 12, 13 prominent medical societies and advocacy groups sent a letter to the Centers for Medicare and Medicaid Services (CMS) requesting a postponement until, at least, July 1 due to industry and physician confusion in implementing the requirement. In the letter, the societies and advocacy groups request administrative simplification stating, “[w]hile section 6407 of PPACA requires that the physician document that the encounter took place, the CMS rule and interpretive guidance requires much more, including a narrative as to why the patient clinical findings specifically support Medicare coverage. As has been reported in our meetings with CMS, many physicians see this added documentation component as unnecessary, duplicative, and unduly burdensome.” The letter closes with recommendations for reducing the paperwork burden on physicians in addition to increasing patients’ access to the physician encounter.

For more information on hospice providers, please contact Abby Pendleton, Esq. and Jessica Gustafson, Esq. at (248) 996-8510 or at (212) 734-0128 or visit the HLP website.

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