Home Health & Hospice Week

COVID-sparked regulatory changes give rise to confusion.

If you furnish private duty services under Medicaid, the CARES Act may not have changed as much as you thought it would.

Reminder: One of the many clauses in the Coronavirus Aid, Relief, and Economic Security (CARES) Act signed into law March 27, 2020, broadened home health ordering under Medicare and Medicaid. The law amends Section 1814(a) of the Social Security Act (42 U.S.C.1395f(a)) to add nurse practitioners, clinical nurse specialists, and physician assistants to the list of clinicians who can order home health (see HCW by AAPC, Vol. XXIX, No. 12-13).

However, the same doesn’t go for Medicaid private duty services, the Centers for Medicare & Medicaid Services recently told a trade group. “CMS clarified that the statutory changes only addressed the home health benefit under Medicaid and not the private duty nursing benefit,” says the National Association for Home Care & Hospice in its member newsletter.

In another clarification, HHH Medicare Administrative Contractors told NAHC they are using the instructions in the Medicare Benefit Policy Manual, chapter 7, section 30.5.1.1 — not CARES Act language — to assess face-to-face physician encounter compliance. “NAHC recommends that HHAs follow the manual instructions until such time that CMS revises the regulations and manual instructions to conform with the provision in the CARES Act for the home health F2F encounter,” the trade group advises.