Home Health & Hospice Week

Don’t miss any new requirements.

If the telehealth proposal in the home health 2021 proposed payment rule is finalized as-is, here are the Conditions of Participation changes under which you’ll operate — and be surveyed:

• Section 409.43 is amended by revising paragraphs (a) introductory text, (a)(1), and (3) to read as follows:
  § 409.43 Plan of care requirements.
     (a) Contents. An individualized plan of care must be established and periodically reviewed by the certifying physician or allowed practitioner.
     (1) The HHA must be acting upon a plan of care that meets the requirements of this section for HHA services to be covered.

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               (3)(i) The plan of care must include all of the following:
                     (A) The identification of the responsible discipline(s) and the frequency and duration of all visits as well as those items listed in § 484.60(a) of this chapter that establish the need for such services
                       (B) Any provision of remote patient monitoring or other services furnished via a telecommunications system and such services must be tied to the patient-specific needs as identified in the comprehensive assessment, cannot substitute for a home visit ordered as part of the plan of care, and cannot be considered a home visit for the purposes of patient eligibility or payment.
                       (C) A description of how the use of such technology will help to achieve the goals outlined on the plan of care.
               (ii) All care provided must be in accordance with the plan of care.

• Section 409.46 is amended by revising paragraph (e) to read as follows:
  § 409.46 Allowable administrative costs.

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                  (e) Telecommunications technology. Telecommunications technology, as indicated on the plan of care, can include: Remote patient monitoring, defined as the collection of physiologic data (for example, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient or caregiver or both to the home health agency; teletypewriter (TTY) technology; and 2-way audio-video telecommunications technology that allows for real-time interaction between the patient and clinician. The costs of any equipment, set-up, and service related to the technology are allowable only as administrative costs. Visits to a beneficiary’s home for the sole purpose of supplying, connecting, or training the patient on the technology, without the provision of a skilled service, are not separately billable.