Case Management

News: Changes on horizon for home healthcare eligibility

Case Management Weekly, June 20, 2012

When your organization is reviewing its home healthcare policies, note that the definitions of home care eligibility may change in the near future, says Jackie Birmingham, RN, MS, CMAC, BSN, vice president emeritus of clinical leadership at Curaspan Health Group in Newton, Mass.

CMS is working on a proposed rule that would expand home healthcare eligibility to more patients.  The proposed rule appeared in the July 12, 2011, Federal Register

Under the proposal, patients would no longer need to be "homebound" to qualify for services. In addition, eligible services could also be provided outside the home, says Birmingham. 

"It wouldn't apply to everybody [who might benefit from home services] but I think it supports the government's initiative to keep people out of nursing homes. It might … make home care more accessible and eligibility more meaningful," she says. 

CMS’ goal is to help more patients, who might otherwise require a nursing home placement, to remain at home. The benefit to the government would be lower-cost care and improved patient satisfaction. 

Editor’s note: This article is adapted from an article that originally appeared in the June Case Management Monthly published by HCPro, Inc.



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