Tag: face-to-face rule

WASHINGTON - CMS in an interim final rule published March 30 appeared to significantly expand access to respiratory therapy by temporarily waiving the coverage criteria and face-to-face requirements during the coronavirus pandemic.The agency says NCDs and LCDs that point to clinical indications for coverage for respiratory equipment— including but not limited to home oxygen, CPAPs, RADs, ventilators and infusion pumps—as well as to face-to-face evaluations, will not apply during the public...

WASHINGTON - The face-to-face requirement only applies to written orders for Medicare payment, according to a bulletin from AAHomecare. "This clarification means that when a state has a prescription requirement annually, a new face-to-face is not required," the association stated. The guidance comes from the NHIC, the Jurisdiction A DME MAC. Even though a supplier does not need a new face-to-face evaluation, it must still obtain a new order and remain in compliance with state regulations, according...

A. With face-to-face (F2F) encounter documentation now required for 166 items of DME and a proposed significant expansion of the prior authorization demonstration project looming, referring physicians who have historically said “my way or the highway” in regard to face-to-face documentation are now being held accountable.  Today, DME providers are more insistent that physicians complete and appropriately document F2F encounters. DME providers know all too well that it no longer makes...

WASHINGTON - The DME MACs on May 29 revised a bulletin on the face-to-face requirement to add information clarifying who may perform the in-person visit and the responsibilities of the ordering physician. The face-to-face exam must be performed by a physician (MD, DO or DPM), physician assistant (PA), nurse practitioner (NP) or clinical nurse specialist (CNS) within six months of the written order for certain DME. The responsibilities of the ordering physician include: documenting that the beneficiary...

A. DME companies need the face-to-face paperwork required by Medicare, and physicians, for whatever reason, have trouble providing it. The push and pull over accurate and complete paperwork documenting medical necessity has always created an issue. In business it is important to understand where another person is coming from to more efficiently work with them. Physicians do not want to have discussions about the importance of complete and accurate paperwork any more than DME representatives...

A. Yes. The right electronic template provides a dynamic, time-efficient and cost effective solution to succeed at the highest level with the face-to-face (F2F) rule in effect since July 1, 2013. CMS came out with guidance for the use of templates around the same time they announced the new F2F rule. CMS recognizes that an electronic template, which is part of the electronic health record (EHR), is a good way to allow physicians to have a standard method of documenting a patient's medical condition.Practitioners...

A. Your organization is unique and the specific operational protocols established by your organization should be unique also. Despite uniqueness, a commonality exists between all DME suppliers when something new, such as the face-to-face rule, is established, and the most important operational protocol for all stakeholders with the face-to-face rule is education.CMS refers to operational protocols as those internal processes established by collaboration of DME suppliers and physicians to ensure compliance...

BALTIMORE - CMS plans to start the new year by enforcing part of its face-to-face rule on Jan 1.On Dec. 19, National Heritage Insurance Company, the Jurisdiction A DME MAC, stated in a bulletin that it would enforce the written order prior to delivery (WOPD) requirement for dates of service on or after Jan. 1.“Providers that weren't getting WOPDs need to start getting them,” said Kim Brummett, senior director of regulatory affairs for AAHomecare. “They are saying, 'Do it.'”CMS...

BALTIMORE - The delay in enforcing the requirement for face-to-face exams does not apply to the requirement for written orders prior to delivery, CGS clarified in a recent bulletin. CGS will begin enforcing the requirement for written orders prior to delivery for dates of service on or after Jan. 1. Enforcement of the face-to-face requirement has been postponed until a future date to be announced in 2014. The requirement was implemented July 1.

WASHINGTON - The delay in the enforcement of the face-to-face rule buys time for HME industry stakeholders to seek changes.One change they'd like to make: A requirement that only physicians can sign off on the face-to-face exam and equipment orders. The requirement has caused delays in patient discharges.“It might be easier in cities where doctors are around all the time, but here, hunting down the doctor can be next to impossible,” said Rose Schafhauser, executive director of the Midwest...