Face-to-face rule moves to Medicaid

Friday, January 29, 2016

WASHINGTON – CMS this week published final regulations for implementing a face-to-face rule for Medicaid.

Starting July 1, physicians must document that they’ve conducted face-to-face visits with Medicaid recipients no more than six months prior to those patients receiving certain home medical equipment and services.

CMS will delay compliance with the rule for up to two years, according to the regulations, which will be published in the Federal Register on Feb. 2.

CMS implemented a face-to-face rule for Medicare on July 1, 2013. The agency began enforcing a written order prior to delivery requirement on Jan. 1, 2014, but it has not begun enforcing the face-to-face visit requirement.

A bill was passed last year that expands the types of healthcare providers who can document the face-to-face visit with Medicare beneficiaries to include physician assistants, nurse practitioners and clinical nurse specialists.

Stakeholders believe the expansion paves the way for CMS to start enforcing the face-to-face visit requirement for Medicare.