Home Health & Hospice Week

While not everything agencies want, at least change is a step in the right direction.

The newly enacted Bipartisan Budget Act may help your home health agency medical review defense efforts - but not as much as it could have.

Industry lobbyists were hoping to secure a change requiring government contractor medical reviewers to  zconsider home health agencies' own medical records in determining eligibility - not just the records of ordering/certifying physicians. Instead, the original language remained, merely allowing rather than requiring HHA supporting documentation.

The law reads, "For purposes of documentation for physician certification and recertification ... on or after January 1, 2019, and made with respect to home health services furnished by a home health agency, in addition to using documentation in the medical record of the physician who so certifies or the medical record of the acute or post-acute care facility (in the case that home health services were furnished to an individual who was directly admitted to the home health agency from such a facility), the Secretary may use documentation in the medical record of the home health agency as supporting material, as appropriate to the case involved."

"The attempt to expand the documentation auditors can rely upon for face-to-face is helpful, especially with the home health Recovery Audit Contractor firing up," notes attorney Robert Markette Jr. with Hall Render. But because the statute says "may" and not "shall," he suspects "the auditors will be less likely to exercise their discretion and rely upon documentation in the home health agency's chart."

But at least the change "is a step in the right direction in easing the burden of the home health faceto- face requirements," LeadingAge says. And Medicare "could still change its policy position on documentation," the association points out.

The National Association for Home Care & Hospice allows that "there's still likely work to be done on the face-to-face/physician certification issue, but progress has been made. Congress has acknowledged the burden and the need to address it.

Do this: Until further changes are secured, Markette advises agencies to continue "to be providing supplemental information to the physician to have them adopt into their record - at least until we start to see what auditors do with this."