CMS’ guidance on the face-to-face encounter requirement has continuds to create confusion among providers to the point that the American Association for Homecare has submitted two letters written to the General Counsel at CMS seeking clarification.
The first letter sought to straighten out an inconsistency between the unambiguous language requiring a face-to-face encounter that was written by Congress and CMS’ implementing guidance. Based on CMS’s guidance, contractors have instructed providers that only the physician or practitioner who performed the face-to-face encounter can sign the written order prior to delivery.
AAHomecare stated that it believes Congress’ intent was to allow different practitioners to complete the requirement, and that CMS has arbitrarily restricted who can perform the encounter when a physician signs a WOPD. The Association requested that CMS and its contractors revise their guidance.
The second letter focused on CMS’ 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.
Providers traditionally received the documentation — commonly referred to as a detailed written order (DWO) — between delivery and billing. The timing sought to avoid any possible disruption in beneficiary care that requiring a DWO prior to delivery would create.
AAHomecare state it requested CMS to withdraw its guidance 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.”