Home Health & Hospice Week

Get ready for another physician headache. If you furnish management and evaluation to patients as their only skilled service, you'll have a lot more work securing your Medicare payment for them starting Jan. 1. That's because the Centers for Medicare & Medicaid Services has finalized a requirement to have ordering physicians write "a written narrative of clinical justification" for the services, according to the home health prospective payment system 2010 update in the Nov. 10 Federal Register (see Eli's HCW, Vol. XVIII, No. 39, p. 298). CMS will require the narrative for both certs and recerts, the final rule says. The narrative must prove that "the patient's overall condition supported a finding that recovery and safety could be  ensured only if the care was planned, managed, and evaluated by a registered nurse." Securing this narrative from docs will be "very burdensome," warns clinical consultant Judy Adams with Adams Home Care [...]