See the rule at http://www.homeandhospicecare.org/Final%20Home%20Health%20Face-to-Face%20Encounter%20Rule.pdf
Home health, hospice patients need to have face-to-face encounter with physician: New Medicare rule
A new federal regulation issued by Medicare in November will create a crisis for approximately 4.5 million home health and hospice service patients. Starting on January 1, homebound elderly and disabled patients as well as hospice patients will now need to have a "face-to-face encounter" with a physician or nurse practitioner if they want to receive care under Medicare.