Congressional Letter Opposing Face-to-Face Documentation Requirements Sent to CMS’ Administrator

Last week, a bipartisan group of 75 Members of Congress sent a letter to Marilyn Tavenner, the Administrator for the Center for Medicare and Medicaid Services (CMS), on the overly complicated and burdensome face-to-face (F2F) physician encounter documentation requirements promulgated by CMS.  The letter asserts that these documentation requirements go well beyond what the Affordable Care Act (ACA) required.

The letter was circulated by Representatives Tom Reed (R-NY), Paul Tonko (D-NY), Chris Smith (R-NJ), and Robert Andrews (D-NJ), and was sent to every congressional office asking for additional Member support.

New York and New Jersey NAHC members initiated the sign on letter and NAHC members and advocates were integral in the effort to get the 75 lawmakers to add their name to the letter.

HCAF worked diligently to get Congressmen from Florida to add their names to the letter. We are very thankful to Rep. Kathy Castor (D-FL 14) and Rep. Alcee Hastings (D-FL 20) for including their names on the letter.

The final 75 lawmakers who signed the letter are Democrats and Republicans from every region of the country representing rural, urban and suburban populations. In the letter, the lawmakers express their primary concerns with the F2F encounter requirement:

”[U]nder the Affordable Care Act (ACA), Congress included a provision aimed at increasing collaboration between home health agencies and physicians. This provision, implemented by the Centers for Medicare and Medicaid Services (CMS), is known as the Face-to-Face (F2F) Encounter Requirement. While we support the need for direct encounters between patients and physicians to occur, the current regulations contain complicated, confusing, and overlapping documentation requirements that exceed the intent of the law passed by Congress. These requirements have imposed a significant burden on home health providers and physicians in our districts.

As implemented by CMS, physicians are now required to document, sign and date an additional form with a narrative of the patient’s condition in order to justify home care services. Home health agencies must obtain this signed form prior to billing for Medicare home health services… Prior to billing for Medicare home health services, home health agencies already must obtain a signed and dated form from the physician which outlines the full plan of care…We have heard from home health agencies that believe as a consequence, these new forms are counterproductive to the underlying F2F intent.”

HCAF and NAHC will be working with the sponsors of the letter on follow-up with CMS.  Please continue to send Mary Carr ( your examples of F2F claims denials that you do not believe were justified, as well as physician complaints about the F2F documentation requirements, to aid in our advocacy with CMS.

To read the full article that was sent to Ms. Tavenner, as well as to see the final list of signees, please click here.

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