Entry By: Eileen Bach, PT, M.Ed, DPT
Hello, home care!
4/1/2011 marks the start date of several important Medicare changes for the home care setting – one is the physician face to face certification and the second is the new rehab therapy documentation requirements and time points. Pasted below is a Medicare posting regarding MD face to face requirement. Both of these new requirements are the subject of review and lively discussions at my seminar “Home Health Care: Advancing Your Skill Set“.
Best wishes, Eileen Bach
FROM CMS.gov website
Effective April 1, 2011, the Centers for Medicare & Medicaid Services (CMS) expects home health agencies and hospices have fully established internal processes to comply with the face-to-face encounter requirements mandated by the Affordable Care Act (ACA) for purposes of certification of a patient’s eligibility for Medicare home health services and of recertification for Medicare hospice services.
Section 6407 of the ACA established a face-to-face encounter requirement for certification of eligibility for Medicare home health services, by requiring the certifying physician to document that he or she, or a non-physician practitioner working with the physician, has seen the patient. The encounter must occur within the 90 days prior to the start of care, or within the 30 days after the start of care. Documentation of such an encounter must be present on certifications for patients with starts of care on or after January 1, 2011.
Similarly, section 3131(b) of the ACA requires a hospice physician or nurse practitioner to have a face-to-face encounter with a hospice patient prior to the patient’s 180th-day recertification, and each subsequent recertification. The encounter must occur no more than 30 calendar days prior to the start of the hospice patient’s third benefit period. The provision applies to recertifications on and after January 1, 2011.
On December 23, 2010, due to concerns that some providers needed additional time to establish operational protocols necessary to comply with face-to-face encounter requirements mandated by the Affordable Care Act (ACA) for purposes of certification of a patient’s eligibility for Medicare home health services and of recertification for Medicare hospice services, CMS announced that it will expect full compliance with the requirements, beginning with the second quarter of CY2011.
Throughout the first quarter of 2011, CMS has continued outreach efforts to educate providers, physicians, and other stakeholders affected by these new requirements. CMS has posted guidance materials including a Medlearn article, questions and answers documents, training slides, and manual instructions which are available via CMS’ Home Health Agency Center and Hospice webpages. CMS’ Office of External Affairs and Regional Offices contacted state and local associations for physicians and home health agencies and advocacy groups to ensure awareness about the face-to-face encounter laws, and to distribute the educational materials.
CMS will continue to address industry questions concerning the new requirements, and will update information on our Web site at http://www.cms.gov/center/hha.asp and http://www.cms.gov/center/hospice.asp.
Hi Dr. Bach
I recently went to this course in Ft. Lauderdale. I have been pulling together resources that you suggested. I had some difficulty finding where I could order the exercise book for older adults from the CDC. Also, I was unable to visit the link you provided in the back of the book. You mentioned a few links that were edited incorrectly, so I wasn’t sure if that was the case. Perhaps, it is blocked from my work computer, but I was able to access this site. Either way, could you lead me in the right direction. Thanks.
Hi Valerie, the instructor link on the last page in the book is correct so you should be able to access the documents I loaded on that page.
The CDC just updated some of their sites; try entering Fit for Life or Senior adult exercises on the home page of CDC.gov in your search engine such a google and you should find the senior exercise information.
As I mentioned in the course, links are only good on the 1st day accessed so if any link does not work, just type the topic in your search engine and you will find the latest link.
My work site ( in order to be super secure) also blocks a lot of access to web sites, so you may want to try on a non- work computer to see the pages.
Best wishes,
Eileen Bach
As a woman with an elderly mother I really had to research nj homecare to find the best fit for her. Thank goodness I found Visiting Angels. I was very fortunate for them to assist me and were a pleasure to work with.
Lola,
I am glad that you found home health care a positive experience in caring for your mother.
Best wishes,
Eileen Bach
Hi Eileen,
I am planning to start Home health Care Agency in Chicago. Before that I have to attend your seminar in Chicago or neighboring States. Please if you have any future seminar in Chicago or other places let me know
Thanks
Amruthur Ramachandran (Ram)
Amruthur,
Thank you for your interest in my Home Health seminar. I applaud you for seeking to learn more about home care as you begin working in this setting.
My seminar dates are posted on the Summit webpage – go to Live Seminars, look in Geriatrics, PT, OT, etc and you will see Home Health Care:Advancing Your Skill Set which is my program. Open the link and all of my future seminars are listed.
I am in AZ and Utah in July, Penna/NJ in Sept and we are finalizing Octobr and November in the next month.
Best wishes,
Eileen
I am wondering if you will have any of the Home Care Advancing your Skill Set seminars in South Carolina
Hi Brenda, thank you for your interest in my seminar. I am not scheduled to be in South Carolina at this time. My fall schedule (Sept-Nov) has not yet been set but should be finalized in the next few weeks.
You can check in for an update on seminars in your area by using the Browse by Topic or select your state on the Live Seminars page here.
Best wishes,
Eileen
Our agency would be eager to take your Home Care seminars but because the enxt one is scheduled on a Sunday (5/22/11), we are not able to participate. This is a government agency and our offices are open Monday through Friday. We would appreciate your consideration when making the schedule.
Hi Thad, please check the schedule again. I do not conduct any seminars on Sundays. You did not indicate your location so perhaps you are looking at a different home care course or different speaker on the Summit site.
My home care seminar is titled “Home Health Care: Advancing Your Skill Set” and my seminar is an inperson seminar only (not webcasted). My next seminars are held: Thurs. 5/12 is in Cincinnati, OH, Friday 5/13 is in Dayton, OH, Sat. 5/14 is in Columbus, OH, Mon. 5/16 is Cleveland, OH and Tuesday 5/17 is Pittsburgh,PA. The next dates would be in July in AZ and Utah.
Hope this info on my seminars is helpful.
Best,
Eileen
Venkat, thank you for your interest in my seminar. From May 12th – 17th, I will be holding 4 seminars in Ohio cities and 1 in Pittsburg, PA. I do not have any scheduled seminars in Virginia or Maryland at this time.
On the Summit web page, choose Live Workshops tab and on the left of page, you can select Browse by topic or you can select the state on the map and see all offered seminars there.
Best wishes,
Eileen
Hello, I am interested in your seminar. Do you have one coming up in VA/MD area please. Thanks