CMS Issues Guidelines Regarding Homebound Qualification for Medicare
CMS last week issued "more flexible" guidelines for home health agencies and contractors in determining whether severely disabled Medicare beneficiaries qualify as homebound. Under the new instructions, those Medicare beneficiaries who qualify as homebound will not lose home health services should they need to leave their homes for a short time for special occasions, such as family reunions, graduations and funerals. The new language in the program manual clarifies that the determination of homebound status should be made over a period of time, rather than on a daily or weekly basis. In addition, the new guidelines expand the list of reasons for occasional absences from the home and include late stages of amyotrophic lateral sclerosis, or ALS, or other neurodegenerative disabilities as examples of conditions that would "indicate that a patient cannot leave his or her home." CMS Administrator Tom Scully said, "While Congress weighs the homebound definition in current law, we have the responsibility to make sure that chronically disabled people who are considered to be homebound can live a full life ... without the fear of losing vital benefits" (HHS
release, 7/26).
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