– Join us for Our Medicare Home Health Webinar · January 23 at 3pm EST–
Guest Speaker: Physical Therapist Cindy Krafft, PT, MS
Last week, the Center for Medicare Advocacy laid out our Medicare Platform for the New Congress. One of the core considerations to improve Medicare for all beneficiaries, now and in the future, is the need to reduce ongoing barriers to coverage and care. One of the key areas facing a crisis in access to Medicare coverage is home health care. We detailed this crisis in our 2018 Issue Brief Series. Going forward, the Center will push for access to Medicare-covered home care for all beneficiaries who meet coverage criteria, advance access to home health aides, and resolve conflicts between payment models and coverage laws.
Medicare-Covered Home Health Care Can Help People with Long-term Conditions
Medicare covers certain health care provided at home when an individual is unable to leave home without help and has a doctor’s order for home care that includes skilled nursing and therapy. There is no time limit to coverage as long as the individual continues to need help leaving home and needs skilled nursing or therapy. When these standards are met, Medicare also covers care provided by home health aides.
The Medicare home health benefit has been misunderstood and underutilized. People are often told Medicare will not pay if a person’s condition is not “improving.” This is not true. Medicare is available for skilled nursing and therapy intended to maintain a person’s condition, prevent deterioration, or slow decline.
The Center for Medicare Advocacy, in partnership with the John A. Hartford Foundation, is working to spread the word and help people around the Country get access to Medicare and the necessary home care they need.
What services are covered under the Medicare home health benefit?
- Skilled nursing
- Home health aides for up to 28 hours a week combined with skilled nursing care (in some cases, up to 35 hours a week, if needed, as documented by the doctor)
- Skilled physical therapy, occupational therapy and speech language pathology services
- Medical social services
- Medical supplies
Helpful Tips:
- Family members cannot be required to help provide care in order for the patient to receive Medicare coverage.
- Home health agencies must submit a claim to Medicare upon the request of a beneficiary. A claim decision is required in order to appeal.
- A new rule prohibits agencies from discontinuing services without a doctor’s order.
- The doctor is the patient’s most important ally in obtaining and retaining home care.
The Center for Medicare Advocacy has developed numerous resources including brochures, checklists, and an infographic to help beneficiaries, and those who help beneficiaries, understand and access Medicare home health coverage. These resources are available at https://www.medicareadvocacy.org/medicare-info/home-health-care/
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Learn More! Join Us for our Medicare Home Health Webinar
Join us on January 23, 2019 for Medicare Home Health Updates to learn more about Medicare law, discuss a case study, and learn from a successful physical therapist’s experience in providing Medicare-covered care. Center attorneys will be joined by special guest Cindy Krafft, PT, MS, HCS-O, who brings more than 20 years of home health expertise that ranges from direct patient care to operational/management issues as well as a passion for understanding regulations. For the past 15 years, Cindy has been a nationally recognized educator in the areas of documentation, regulation, therapy utilization and OASIS. She currently serves on multiple Technical Expert Panels with CMS Contractors working on clinical and payment reforms.
Ms. Krafft has been involved at the senior leadership level for the Home Health Section of the American Physical Therapy Association for more than 10 years and is the immediate Past President. She has written three books: The How-to Guide to Therapy Documentation, An Interdisciplinary Approach to Home Care, the soon to be released Handbook to Home Health Therapy Documentation – and co-authored a fourth, The Post-Acute Care Guide to Maintenance Therapy with her business partner Diana Kornetti PT, MA, HCS-D.
