F2F Physician Survey

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F2F Physician Survey

Thank you for agreeing to take this very short 10 question survey. It should take less than 5 minutes to complete. PLEASE ANSWER ALL QUESTIONS – ONLY ONE ANSWER PER QUESTION

1.Which state is your primary place of business? ______

2.When was the last time you referred a patient to Medicare-covered care delivered at their home?

Within the past 30 days

Since April 1 this year

This year, but prior to April 1

Before this year

Never

3.As of April 1, 2011, new Medicare rules require that a physician document and certify that he or she has personally met face to face with each patient being referred to home health care. As part of this certification, the physician or his/her staff must write a narrative of the patient’s condition and include a specific explanation as to why that patient qualifies for Medicare coverage of home health care. In general, do you approve or disapprove of the documentation that Medicare is requiring for patients referred to home health care?

Approve

Neither Approve or Disapprove

Disapprove

4.Compared to the previous certification requirements prior to April 1, are the new Medicare documentation requirements for home health referrals… (ROTATE TOP TO BOTTOM, BOTTOM TO TOP)

Significantly easier to administer

Somewhat easier to administer

Requires the same effort to administer

Somewhat more burdensome to administer

Significantly more burdensome to administer

5.Do the new Medicare documentation requirements for home health referrals make it:

More likely that patients will be referred to home health care

Have no impact on whether patients will be referred to home health care

Less likely that patients will be referred to home health care

6.Do you think the new Medicare documentation requirements for home health referrals will have…

A significantly positive impact on the health of Medicare patients

A somewhat positive impact on the health of Medicare patients

Have no impact on the health of Medicare patients

A somewhat negative impact on the health of Medicare patients

A significantly negative impact on the health of Medicare patients

7.Regarding the new Medicare documentation requirements for home health referrals, which of the following opinions is closest to your own?

You approve of the new documentation requirements

You think the new documentation requirements are burdensome and should be simplified

You will now see a few proposals to change the current Medicare documentation requirements for home health referrals. For each one, please tell me if your favor or oppose the proposed change.

8.Allow an existing order and physician certification for home health services, which includes a certification that the encounter occurred but excludes the narrative on why the patient meets Medicare coverage criteria,to satisfy the Medicare documentation requirements for home health care for patients discharged from the facility. Would you favor or oppose making this change to the Medicare rules?

Favor

Neither favor nor oppose

Oppose

9.Keep the face-to-face physician requirement but allow the physician to complete a simplified one page form, with no requirement for a written narrative. Would you favor or oppose making this change to the Medicare rules?

Favor

Neither favor nor oppose

Oppose

10.Use the existing Form 485 documentation to satisfy the Medicare documentation requirements for home health care. Would you favor or oppose making this change to the Medicare rules?

Favor

Neither favor nor oppose

Oppose

Thank you for your time!

PLEASE FAX COMPLETED SURVEYS TO 703-739-0664