For Families, Understanding New Medicare Home Health Restrictions and Alternatives

Posted on May 17, 2012


Offering guidance for physicians, non-physician practitioners, physician support personnel and home health agencies, the Centers for Medicare & Medicaid Services clarified last week that it requires face-to-face encounters and documentation when providers transfer hospital and other patients to the home health setting.

To meet certification requirements–and, by extension, home health payment requirements–a physician must certify that the patient needs home health services and has a care plan, according to the Medicare Learning Network article. The doctor or another nonphysician practitioner with privileges (i.e., nurse practitioners, clinical nurse specialist, certified nurse midwife or physician assistant) must have a face-to-face encounter with the patient within 90 days before the start of home healthcare or within 30 days after the start date, according to CMS. Providers can conduct the encounter remotely via telehealth technology, CMS said.

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The physician also must record the face-to-face encounter, which serves as documentation when the home health agency bills Medicare.

The new Medicare rule is part of the U.S. Health & Human Services revamping of regulations in which it hopes to increase efficiency and alleviate administrative burdens on providers. HHS has reported “significant progress” in privileging and credentialing and documentation regulations for both in-person and telemedicine visits, in particular.

via Patient home transfers call for encounter, documentation – FierceHealthcare.

Medicare only pays for some of the care that people need to stay in their homes and they are getting more restrictive on what they will cover.  There are other resources to assist in keeping us in our homes as we age and that is private duty home care.  BrightStar specializes in this kind of care and we would be honored to be able to help you or a loved one.

BrightStar Care of Downtown Houston

BrightStar is an in-home health care company designed to help, give us a call at 832-730-1255.

All of our services are personalized to fit the specific needs of the client.  We work with clients and their families to design a customized care plan, and we match each client with a qualified, pre-screened caregiver.

From childcare to elder care, the BrightStar of Downtown Houston team provides peace of mind. We are available 24 hours a day, 7 days a week. Our Director of Nursing ensures that each client receives the highest level of care administered by highly qualified personnel.

Home Healthcare and Staffing Services Provided

  • Alzheimer’s and Dementia Care
  • Shopping and Transportation Services
  • Newborn/Multiples Care
  • Sitting/Companion Service
  • Nanny Service
  • And much more

About Our Home Healthcare and Staffing Providers
The answer to your question is “Yes, we can!” Just tell us what you need; we’ll custom tailor a service plan and make all of the necessary arrangements. We are here to help our clients and their families live their best. Let us know how we can be of service.

Proudly serving Bunker Hill VillageRiver Oaks, Bellaire, West University, The Heights, Hunters Creek, Midtown and the Medical Center.