A lawsuit over Medicare home health face-to-face physician encounter requirements being prepared by the National Association for Home Care and Hospice is ready to go, the association said via its website Wednesday. But the association is meeting with Centers for Medicare and Medicaid Services to discuss the issue further.
Due to industry concerns stemming from the face-to-face rule, NAHC’s Board of Directors approved a lawsuit challenging the requirement that physicians provide sufficient narratives on a patient’s homebound status and need for skilled care.
“The lawsuit is ready to go,” NAHC told its membership on its website. “The intention is to file it in Federal District Court in Washington, D.C. with NAHC as the named plaintiff having ‘associational standing’ to bring the case on behalf of its members.”
The organization recaps three claims covered under the lawsuit: that the Centers for Medicare and Medicaid Services do not have the authority to require the physician narratives; to the extent that they can require them, law requires CMS to promulgate standards for compliance that affected parties can understand and meet; and Medicare can’t deny a claim solely on the basis of the face-to-face encounter documentation.
CMS has expressed its consideration for the industry’s concerns, NAHC said, and willingness to resolve the issue without litigation. The association is scheduled to meet with CMS May 8. It has also requested a congressional hearing before the House Committee on Energy and Commerce on the issue though the hearing is not likely to be scheduled before the coming election season.
Written by Elizabeth Ecker