Health Care Reform

New Medicare requirements for home health and hospice

Effective January 1, 2011, the Patient Protection and Affordable Care Act implements a new law for Medicare providers that requires the physician or other health care professional to perform a face-to-face examination of the patient when certifying or recertifying home health care or hospice services. For home health, the provider must document who saw the patient and how the patient's clinical condition supports a homebound status and need for skilled care services as part of the certification for home health services.

The face-to-face encounter must occur within 90 days prior to the start of home health care, or within 30 days after the start of care. For hospice, the face-to-face encounter must occur no more than 15 calendar days prior to recertification. While the long-standing requirement for providers to certify the need for home health and hospice remains unchanged, this new requirement assures that the order is based on current knowledge of the patient's condition.

  • Learn more (PDF) about the implementation of this law.