NAHC v US DHS
Priscilla Demonstrating a Proper Face-to-Face Encounter. She continues to work on documentation skills.
I have never been a big fan of associations and organizations. I am not a joiner in general. Specifically, I have been very frank about my feelings towards the National Association of Home Care and Hospice. I believe that in the past they took on causes that benefited some agencies at the expense of others. In many ways, it is almost impossible to be an organization representative of all agencies of all sizes in all parts of the country.
As of June 5, that changed. William A. Dombi, attorney for the plaintiff – your association – has filed suit against the US Department of Health and Human Services. NACH is challenging the requirements regarding documentation of the Face-to-Face encounter. They allege that Medicare is enforcing the Face to Face encounter requirements in ways that were never intended and are not legal. They note that these retroactive denials are made outside of the consideration of the care needed by the patient or the quality of the care rendered to the patient.
This is good stuff, y’all.
Because I was so outspoken and passionately against the position NAHC took in the past regarding other issues, I owe it to the Association (and to myself) to be as outspoken and passionate in my support of this lawsuit.
If NAHC asks anything of its members, please cooperate to the best of your ability. If nothing else, send the board at NAHC responsible for approving the filing of the claim a note of gratitude. This is one position that NAHC has taken that benefits all agencies, patients, and the Medicare trusts.
I can respect that.
It is difficult for any organization to be run in a way that no member feels neglected or over-burdened. But, there are times when you just can’t escape the value of an organized response to an entrenched and powerful common foe.
I agree. It is difficult to take the feds on because they rarely lose and they have unlimited resources. Everything else aside, it is entirely possible that Dombi will die of old age while waiting for the first hearing. Meanwhile, resources and energy are tied up in a huge case and other projects are set aside to focus on the big one.
Some cases have been won. Brian Daucher/Hospice Caps and The Jimmo decisions are good examples. In those examples as well as this one, I suspect that the organizations/lawyers knew the odds of losing were high. Nobody wants a case they have a high chance of losing. But, they also know exactly what it takes to win and I wonder how many lawsuits have not been filed because they had no chance to win as opposed to a small chance. We shall see. I am cautiously optimistic.
This is an answer to prayers. CMS is changing definitions and requirements monthly. As implied, there is less concern for the beneficiaries and more concern for saving $$ at the expense of the providers. Thank you Bill Dombi!