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Medicaid Face-to-Face Requirement Proposed Rule Details & Comment Information

Most Notable Aspects of the Rule

The Centers for Medicare & Medicaid Services posted the proposed rule on the Medicaid face-to-face encounter requirements. The proposal aligns the Medicaid time frames with the Medicare time frames (90 days prior to start of care, 30 days after start of care) while providing some flexibility to states to determine other aspects such as the content and form of documentation.

For Medicaid recipients, the certifying physician’s documentation would state the attending physician has had the encounter with the physician. CMS believes "this enhanced communication will result in an improved transition of care from the hospital or post-acute setting to the home health setting."

That rule also clarifies that unlike the Medicare face-to-face requirement, states may not apply homebound criteria to Medicaid patients or confine the definition of home health services to services provided in the home.

Florida already has a requirement in place (F.S. 409.905(4)(c)) that a patient who will be receiving Medicaid services must see the ordering physician within 30 days prior to the initiation of those services. This state-specific requirement may meet the federal standard and HCAF will monitor the issue closely to determine that.

Submitting Your Comments to HCAF

HCAF will submit comments to CMS on behalf of the Florida home health care industry. Please submit your agency's comments to HCAF by emailing Kyle Simon, Government Affairs & Member Advocacy Director, at Comments are due by the close of business on Friday, August 5. 

Submitting Your Comments to CMS

To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on September 6, 2011. In commenting, please refer to file code CMS-2348-P.  Because of staff and resource limitations, CMS cannot accept comments by facsimile (FAX) transmission.

You may submit comments in one of four ways (please choose only one of the ways listed): 

  1. Electronically. You may submit electronic comments on this regulation to Follow the instructions under the "More Search Options" tab.
  2. By regular mail. You may mail written comments to the following address ONLY:

    Centers for Medicare & Medicaid Services
    Department of Health and Human Services
    Attention: CMS-2348-P
    P.O. Box 8016
    Baltimore, MD  21244-8016

    Please allow sufficient time for mailed comments to be received before the close of the comment period.
  3. By express or overnight mail. You may send written comments to the following address ONLY:

    Centers for Medicare & Medicaid Services
    Department of Health and Human Services
    Attention: CMS-2348-P
    Mail Stop C4-26-05
    7500 Security Boulevard
    Baltimore, MD 21244-1850
  4. By hand or courier. If you prefer, you may deliver (by hand or courier) your written comments before the close of the comment period to either of the following addresses:

    For delivery in Washington, DC:
    Centers for Medicare & Medicaid Services
    Department of Health and Human Services
    Room 445-G, Hubert H. Humphrey Building
    200 Independence Avenue, SW
    Washington, DC  20201
    (Because access to the interior of the Hubert H. Humphrey Building is not readily available to persons without Federal government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the comments being filed.)  

    For delivery in Baltimore, MD:
    Centers for Medicare & Medicaid Services
    Department of Health and Human Services
    7500 Security Boulevard
    Baltimore, MD  21244-1850
    (If you intend to deliver your comments to the Baltimore address, please call (410) 786-7195 in advance to schedule your arrival with one of our staff members.)

    Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received after the comment period.

    For information on viewing public comments, see the beginning of the "SUPPLEMENTARY INFORMATION" section.  

Supplemental Information

Inspection of Public Comments: All comments received before the close of the comment period are available for viewing by the public, including any personally identifiable or confidential business information that is 

included in a comment.  We post all comments received before the close of the comment period on the following website as soon as possible after they have been received: Follow the search instructions on that Web site to view public comments.

Comments received timely will also be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, at the headquarters of the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 4 p.m. EST.  To schedule an appointment to view public comments, phone 1-800-743-3951. 

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