Home Health & Hospice

Insider’s scoop | ’Homebound’ patients who drive

Homecare Insider, May 2, 2016

Editor’s note: This week’s Insider’s scoop is from The Home Health Guide to Medicare Service Delivery, 2016 Edition. Newly updated to reflect the 2016 home health PPS final rule, this ubiquitous resource offers a one-stop solution for home health professionals looking for answers to their Medicare compliance questions. Click here for more information.

Can a patient who drives be considered homebound? CMS has said that patients who drive should not automatically be disqualified from Medicare coverage. Look at all the facts. The question of medical necessity of homecare services comes intp play. If the patient drives, can he or she drive to a clinic or outpatient department to receive healthcare services? In most cases, the anser is yes, so the patient wouldn't need homecare servuces. Homecare is not a convenience for those who can leave home. However, if  a patient lives in a very rural area and the nearest healthcare facilities are 75 miles away, driving that far might be a necessity, not an option.

When evaluation your patient's homebound status, you must first decide tht the patient is eessentially confined to home and then determine whether or not absences from the home meet the criteria.