The National Association for Home Care & Hospice reports that it has received clarification from the Centers for Medicare and Medicaid Services regarding some discrepancies between Medicare regulations and the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The issues in question include face-to-face requirements for home health certifications, and whether allowed non-physician practitioners may order private duty nursing under Medicaid.
Regarding the face-to-face question, CMS provided this, according to NAHC: A face-to-face encounter with the patient must be performed by the certifying physician, allowed practitioner who cared for the patient in the acute or post-acute care facility, or an allowed non-physician practitioner. NAHC recommends that agencies continue to follow the language in Medicare Benefit Policy Manual, chapter 7, section 30.5.1.1, until CMS revises the manual to conform with the CARES Act on this issue.
As for whether allowed non-physician practitioners may order private duty nursing under Medicaid, CMS clarified that the statutory changes only addressed the home health benefit under Medicaid and not the private duty nursing benefit.
Another issue NAHC sought guidance on is who may sign the plan of care. CMS pointed out that Chapter 7 of the Benefit Policy Manual includes erroneous language on this subject. The agency referred providers to FAQs found in the program guidance and information on the CMS.gov website about our response to COVID-19.
“We state that the home health conditions of participation do not prohibit home health agencies (HHAs) from accepting orders from multiple physicians, and now with the recent statutory change, nurse practitioners, physician assistants, and clinical nurse specialists (i.e., allowed practitioners),” CMS said.
