Revise Face-to-Face Physician Encounter/Physician Documentation Requirements

A flawed provision of the Patient Protection and Affordable Care Act requires a patient to have a face-to-face encounter (F2F) with a physician to certify the need for Medicare home health services. It includes burdensome paperwork requirements on physicians that have caused confusion among physicians, home health agencies, and other parties involved.

Unfortunately, the confusion and burdensome paperwork from the rule have limited access to care and posed a high risk for denying coverage to Medicare beneficiaries who are homebound and in need of skilled nursing care. Congress should act now to revise the F2F requirement.

Contact your member of Congress to revise the F2F requirement. Read more.

Please contact your members of Congress today to urge them to revise the F2F requirement.

Subject:

Repeal or Revise Face-to-Face Physician Documentation Requirement

Dear Official,

We need your help to ensure continued access to the Medicare home health benefit in our state.  The Patient Protection and Affordable Care Act of 2010 requires that a patient have a face-to-face encounter (F2F) with the physician who certifies the need for Medicare home health services.  While the intention was to gain greater physician involvement in ordering home health services, CMS’s implementation of the face-to-face encounter rule has led to great confusion among physicians, home health agencies, and other parties involved.

The main problem is the burdensome paperwork requirements on physicians.  CMS has tried to mitigate the confusion through various modifications, but the requirements remain difficult to understand and apply.  As a result, the rule is creating a barrier to access to care and poses the high risk that patients who are, in fact, homebound and in need of skilled care will be denied Medicare coverage.

Congress should revise the face-to-face provision requiring CMS to also consider the home health agency's patient record when reviewing claim status. By doing so, Medicare Administrative Contractor analysts will have all necessary information for claim determination.

Please cosponsor H.R. 2663, legislation that will revise the face to face encounter requirement so that home health claims will no longer be improperly denied.

Regards, Your Name

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