F2F Requirement Confusion Persists

WASHINGTON (Feb. 20, 2014)—AAHomecare’s Regulatory Council recently submitted two letters to the General Counsel at CMS. Both letters are related to continued confusion caused by CMS’s guidance on the face-to-face encounter requirement. The first letter focused on an inconsistency between the unambiguous language requiring a face-to-face encounter written by Congress and CMS’s implementing guidance. Based on the guidance, contractors have instructed providers that only the physician or practitioner who performed the face-to-face encounter may sign the written order prior to delivery (WOPD). AAHomecare pointed out that CMS has arbitrarily restricted who can perform the encounter when a physician signs a WOPD. AAHomecare believes that Congress’ intent was to allow different practitioners to complete the requirement and has requested that CMS and its contractors revise their guidance. The second letter focused on the alarming amount of confusion caused by CMS’s Dec. 5, 2013, announcement that providers must obtain a WOPD and documentation that the WOPD was based on a face-to-face encounter, even though the face-to-face encounter requirement had been delayed. The documentation, commonly referred to as a detailed written order (DWO), has traditionally been received by providers between delivery and billing. This process avoided potential disruption to beneficiary care that requiring a DWO prior to delivery would create. AAHomecare requested that CMS withdraw its “clarification” and delay enforcement of all elements of the final face-to-face rule until it has addressed every outstanding implementation issue. “These two letters point out to CMS that their interpretation of the face-to-face regulation makes complying with this regulation overly burdensome and changes the intent of the regulation,” said Judy Bunn, compliance manager at Medical Service Company and a member of AAHomecare’s Regulatory Council. “Delay, and now partial enforcement of the regulation, leaves ordering physicians, referral sources, providers and patients confused. We do not believe this was the initial intent of Congress.”