![\"\"](\"https:\/\/advantagehcconsulting.com\/blog\/wp-content\/uploads\/2018\/07\/Physician.jpg\")
<\/p>\n<\/p>\n
F2F reform is what\u2019s really needed, expert urges.<\/em><\/strong><\/span><\/p>\n After years of punishing claims denials based on a physician requirement to furnish an estimate of service length for a recert, Medicare is poised to pull back the requirement.<\/p>\n \u201cWe are proposing \u2026 to eliminate the requirement that the certifying physician must estimate how much longer skilled services will be needed as part of the recertification statement,\u201d the\u00a0Centers for Medicare & Medicaid Services\u00a0<\/strong>says in the 2019 Home Health Prospective Payment System proposed rule released July 2.<\/p>\n This idea came from last year\u2019s solicitation in the 2018 HH PPS rule for regulatory burden reduction, CMS indicates in the rule scheduled for publication in the July 12\u00a0Federal Register<\/em>.<\/p>\n \u201cWe have determined that the estimate of how much longer skilled care will be required at each recertification is not currently used for quality, payment, or program integrity purposes,\u201d CMS says. \u201cThe elimination of this recertification requirement would result in a reduction of burden for certifying physicians by reducing the amount of time physicians spend on the recertification process and would result in an overall cost savings of $14.2 million.\u201d<\/p>\n Eliminating \u201cthe redundant physician recertification estimate of continued service is very positive,\u201d cheers reimbursement and appeals expert\u00a0Joe Osentoski\u00a0<\/strong>with\u00a0QIRT\u00a0<\/strong>in Troy, Michigan. \u201cToo many denials are solely on this basis when there is a clear plan of care and duration of service present.\u201d<\/p>\n Plus:<\/span>\u00a0<\/strong>\u201cThere have been issues with those home health patients with ongoing needs and no real actual predicted end of home health (such as urinary catheter changes and management), where the Medicare Administrative Contractor has denied the claim due to no date associated with this estimate,\u201d Osentoski says.<\/p>\n While this change is positive, consultant\u00a0Pam Warmack\u00a0<\/strong>with\u00a0Clinic Connections\u00a0<\/strong>in Ruston, Louisiana, dismisses it as \u201cstraining at a gnat.\u201d Many providers did receive denials initially for the missing estimation statement, but most have since figured out the pretty straightforward requirement. \u201cA great deal of those denials were because the MACs didn\u2019t like where the statement was located. Once we figured out what they wanted and where, the denials began to decline,\u201d Warmack observes.<\/p>\n Instead, HHAs need\u00a0real\u00a0<\/em>change, Warmack urges. \u201cIf you want to reduce the burden of useless regulation, eliminate the horrific face-to-face requirement,\u201d she stresses. \u201cI realize the F2F was part of legislation and might require more than CMS can do in this rule, but that is what is truly needed.\u201d<\/p>\n Source- SuperCoder<\/span><\/i><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"