When Congress passed the federal health care law, it included a provision designed to cut down on Medicare fraud and improve care for patients. A congressional study found fraud is a significant problem in home health care in the Medicare program. Another investigation found some doctors had approved patients for home health with no personal knowledge of the patient they certified. The federal health care law now requires traditional Medicare patients seeking home health care to meet with a physician or a nurse practitioner under a doctor's direction, at least 90 days before they receive the care or within 30 days after the care starts. Some doctors, however, may not be ready to comply with the change. Doctors must certify that a patient is homebound and explain, in writing, why the patient needs the service. The face-to-face requirement will help eliminate fraud and also be better for patients, said Dr. Ed Ratner, medical director of Heartland Home Health Care and Hospice in Roseville, Minn.
