News Brief: Physicians don’t know all needed Medicare rules

News Brief: Physicians don’t know all needed Medicare rules

According to the Office of the Inspector General’s report, The Physician’s Role in Medicare Home Health 2001, 50% of physicians surveyed say they are not clear about the definition to apply when certifying medical necessity for a patient, and 3% say they are unclear on the Medicare criteria for "homebound."

Many physicians also say that they are not able to provide the level of oversight expected of them for Medicare home health patients: 83% of the respondents understand that Medicare expects them to make sure that only medically necessary services are on the plan of care, but only 48% say that they are able to ensure that this is the case.

Although home health staffs are struggling to understand the rules for the home health prospective payment system (PPS), physicians are even less aware of the requirements. In fact, 60% of the physicians surveyed said they had never heard of PPS.

To view full report, go to http://oig.hhs.gov/oei/reports/oei-02-00-00620.pdf.