Medicare Validity Upheld by Courts While Restricting Scope of F2F

Posted on Wednesday, November 4, 2015 11:37 AM

A decision was issued November 3rd by US District Judge Christopher R. Cooper in the NAHC lawsuit which challenged the validity of the Medicare rule regarding the face-to-face narrative requiring physicians to document the face-to-face encounter with their patients.  It was argued by NAHC, that it was unreasonable for claims to be denied based on the narrative, when the entire patient record supports the Medicare coverage. However, Judge Cooper granted “Summary Judgment” to the U.S. Department of Health and Human Services that the F2F law did not preclude the interpretation of “document” that was established by CMS.  The court determined that it is a “reasonable way to verify that an appropriate encounter took place.” NAHC is evaluating the next best steps to take on the ongoing face-to-face requirements controversy.  Val. J. Halamandaris, NAHC’s President stated, “Our fight to overturn these wrongful denials is not over.  We will take every course of action available to protect home health agencies from the wrongful denial of claims under the misguided physician narrative policy.”  For more information click here.

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