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KMAP BULLETIN: Home Health Regulatory Revisions

Date: 07/29/20

KMAP GENERAL BULLETIN 20155 (PDF)

Effective with dates of service on and after August 1, 2020, the following regulatory changes for Medicaid Home Health Services, as documented in Centers for Medicare & Medicaid Services (CMS) 5531 IFC, will be implemented in accordance with revisions to 42 Code of Federal Regulation 440.70.

  1. On orders written by a physician, nurse practitioner, clinical nurse specialist or physician assistant, working in accordance with State law, as part of a written plan of care that the ordering practitioner reviews every 60 days for services described in 42 CFR 440.70 (a) (2) and (3).
  2. On the physician’s orders or orders written by a licensed practitioner of the healing arts acting within the scope of practice authorized under State law, as part of a written plan of care for services described in paragraph (b) (3) the plan of care must be reviewed by the ordering practitioner as specified in regulatory guidance.
  3. Non-Physician Practitioners (NPPs) may certify and recertify a member for home health services.
  4. In accordance with current Kansas law NPPs are required to work in collaboration with a physician within their scope of practice.
  5. Nursing services, as defined by and in accordance with the Kansas State Nurse Practice Act.
  6. Physicians are no longer required to sign off on face-to-face encounters for the initiation of home health services performed by a nurse practitioner, clinical nurse specialist or physician assistant, working in accordance with State law. All other face-to-face requirements are still applicable.

Note: The effective date of the policy is August 1, 2020. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates, once the policy is implemented.