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Home Care Barriers

Certification of Medicare Home Health Services by NPs

Surani Hayre-Kwan, CANP North Bay Chapter member and former CANP President (2012-2014), knows that allowing NPs to certify home health at the time it is needed could eliminate delays in care, and allow patients the right to choose their home as the place to recover. In her position paper, Certification of Medicare Home Health Services by Nurse Practitioners, she points to how Medicare regulations are not keeping up in terms of allowing full practice for nurse practitioners when it comes to providing, billing and being reimbursed for previously identified “physician services."

The Code of Federal Regulations (CFR) Title 42, Section 424.22, is the section that details the requirements for home health services, and the physician-centric language states that Medicare pays for home health services only if a physician certifies (and recertifies) that the patient requires these services (Legal Information Institute, n.d.).

Read Hayre-Kwan’s paper to learn more about the current restrictions around the physician-centric language and why it is time to update Medicare regulations to better reflect today’s advanced practice clinicians.

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