Agencies slam new Medicare rule on home care

Home health agencies, hospitals and consumer groups are complaining that a new rule intended to curb unnecessary Medicare spending will make it harder for senior citizens to get home care services.

Under the requirement, which is to take effect Friday, Medicare beneficiaries will have to see doctors 90 days before or 30 days after starting home health services in order for the home health agencies to be reimbursed. Those face-to-face visits may be a burden for some home-bound frail seniors, as well as those who live in rural areas, the industry says.

Under current law, doctors must prescribe home health care for patients to receive services, but the physicians don't have to see the patients to make that determination.

The new doctor-visit rule, which was included in the health care overhaul, initially was to take effect Jan. 1 and was to require providers to see patients within 30 days before or two weeks after the start of home care. In December, the Centers for Medicare and Medicaid Services delayed implementation until April because of complaints from providers, who claimed that the rule was too stringent and most doctors were unaware of the change. At that time, the CMS also announced that it was expanding the time frame for patients to meet with doctors.

Under the rule, doctors would have to fill out forms that certify that they or other health care providers such as nurse practitioners had seen patients for the specific purpose of determining the patients' needs for home care. This would be in addition to doctors' current duties of prescribing home health care and signing off on care plans, which the home health agencies typically develop.

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