Starting in January 2020, Medicare-enrolled nurse practitioners in Maryland will be allowed to certify home health services as part of the Medicare Total Cost of Care (TCOC) Model.
The change will be effective for services provided on or after Jan. 1, according to change request 11330.
Currently Medicare only pays for home health if a physician — not a nurse practitioner — certifies the beneficiary’s eligibility for the home health benefit.
“Under Maryland law, a nurse practitioner can provide primary care services, but under Medicare rules a beneficiary must be under the care of a physician in order to receive home health care services,” the change request states.
Allowing nurse practitioners to oversee Medicare beneficiaries’ care while in home health “is consistent with Maryland Medicaid rules, other payers in Maryland, CMS’ direction of allowing greater use of non-physician practitioners, and the goal of supporting existing patient/provider relationships under the Maryland TCOC Model.”