Home Health & Hospice Week

Face-To-Face:

Don't Count On The Industry's Lawsuit To Save You From F2F

But stick with your appeals.

If you think you can duck your head in the sand and wait for rescue on the face-to-face requirement, think again.

A federal court has ruled against the industry in the F2F lawsuit filed by the National Association for Home Care & Hospice, the trade group tells its members. In a Nov. 3 decision, the court rejected NAHC’s claim that a narrative requirement in the F2F physician encounter rule is invalid, NAHC says.

However, the F2F rule should not allow “a Medicare claim reviewer to second-guess the medical judgment of a patient’s physician,” the opinion says. “If the rule authorized a reviewer to deny a claim … simply because she disagreed with the physician’s clinical findings or the physician’s reasoning … that would go far beyond what the statute allows.”

NAHC hopes that statement will help agencies win claims appeals for denials based on insufficient narratives, it says.

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