More Documentation Requirements add to Physician Burden
Home health agencies will have less control over new doctor-related payment condition
. Agencies are hoping for some big changes to one troublesome provision in the 2011 proposed payment rule the face-to-face doctor encounter requirement.
The mandate for the face-to-face encounter was in the Patient Protection and Affordable Care Act health care reform law enacted this year. However, the CMS version of the requirement is more stricter than the law calls for.
For instance: The proposed rule also requires that the encounter be for the primary reason home care services are required and that doctors furnish 'unprecedented' physician documentation about the encounter and why the patient meets homebound criteria.
According to industry experts, the proposed face-to-face encounter requirement is riddled with problems for home health agencies. To start with, agencies have very little influence over whether their patients make it to a physician for a visit.
It is absolutely not proper to place a requirement on home health providers for which they have no control whatsoever, as a consultant puts it. "How is the staff of the home health provider supposed to ensure that the patient goes to the physician and that the physician documents right in her office records?"
One can make appointments for patients; however we cannot ensure they keep them; that their transportation is unfailing, that they feel well enough to make the trip. In fact, there are many reasons that patients fail to see the doctor despite the best efforts of the home care staff to make it happen.
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More Documentation Requirements add to Physician Burden