Medicare Compliance & Reimbursement

Homebound requirements are actually prohibited in Medicaid. In addition to the home health agency face-to-face Medicaid requirement, the recent proposed rule addresses other points regarding the Medicaid home care benefit: Homebound. The Centers for Medicare & Medicaid Services reiterates its position that being homebound should not be a requirement for the Medicaid home health benefit, particularly in light of the Olmstead Supreme Court decision requiring states to provide services in community settings when possible. "This is an important difference in the Medicare and Medicaid benefits," stresses Robert Markette Jr. with Benesch/Dann Pecar in Indianapolis. The difference is "crucial" for both admissions decisions and compliance, he says. "Compliance policies and procedures should reflect that Medicare and Medicaid are not identical and do have some key differences -- homebound is one of them," Markette advises. "This is important, because if you are auditing based upon or complying with the wrong program standards, you [...]