Home Health Agencies

September 6, 2011

Starting September 1st, a recently adopted rule adds the requirement for face-to-face encounters between members and physician or other designated providers who determine the medical necessity for Home Health Services. Additionally, the rule includes a time frame in which the face-to-face encounter must occur and this encounter must be related to the reason for which the Home Health Service is ordered.

For example, if the member is in the hospital when the plan of care for Home Health Services is determined, this face-to-face encounter must be documented and sent to the member’s Primary Care Provider for approval prior to submitting claims for these services to MaineCare.