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Proposed bill would help ensure home health agencies are reimbursed by Medicare

July 1, 2015
by Megan Combs, Associate Editor
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To help ensure home health agencies are reimbursed by Medicare for providing patient services, Sens. Robert Menendez (D-NJ) and Pat Roberts (R-Kan.) introduced the "Home Health Documentation and Program Improvement Act of 2015." The legislation was crafted with help from the Visiting Nurses Association of America (VNAA).

Home health agencies are often denied reimbursement because of misunderstood Medicare documentation requirements, according to the VNAA. The legislation improves the approach the Centers for Medicare & Medicaid Services (CMS) uses to collect evidence of reimbursement eligibility. 

"The Home Health Documentation and Program Improvement Act will help ensure that Medicare beneficiaries in need of home health services are able to receive the care they need," said Menendez in a VNAA press release. "The existing home health face-to-face requirement is simple in theory, but has proven unworkable in practice."

"I've been concerned the face-to-face encounter requirement would be particularly difficult for our most vulnerable benficiaries, especially those in rural areas, and could limit access to care," Roberts said in the VNAA press release. "Our bill streamlines this requirement and helps ease the regulatory burden on our providers so we can ensure beneficiaries have access to the care they need, when they need it."

If passed, the legislation would also:

  • Require CMS to develop a standardized form to collect evidence that a beneficiary is eligible for home health services
  • Limit the amount of information that CMS may collect on the form
  • Require CMS to accept forms completed by home health agencies that have been reviewed and signed by the referring doctor

Read more about the legislation here (PDF).