Tag: pre-claim review

North Carolina, Florida Home Health Agencies to See Changes in Review Choice Demonstration

The Centers for Medicare & Medicaid Services (CMS) announced this week that for home health providers subject to the Review Choice Demonstration (RCD) in North Carolina and Florida, the 25 percent payment reduction will be implemented for all claims submitted on or after April 1, 2022. This applies to home health agencies that selected Choice…

CMS Announces Expansion of Review Choice Demonstration to More States

Texas starts in December, North Carolina and Florida in 2020 Updated to include a statement from NAHC President William A. Dombi The Centers for Medicare & Medicaid (CMS) announced today that the next state to participate in the Review Choice Demonstration (RCD) is Texas and it will begin on December 2, 2019. In the same…

Review Choice Demonstration to Begin in Ohio on September 30, 2019

The Centers for Medicare & Medicaid (CMS) announced today that the next state to participate in the Review Choice Demonstration (RCD) is Ohio and it will begin on September 30, 2019. In the same announcement, CMS also stated it anticipates 60-90 days between beginning the demonstration in the remaining states of Texas, North Carolina and…

Advocate Spotlight: Sara Ratcliffe and Liz Vogt

It’s time for another installment of the Advocate Spotlight, in which NAHC Report draws  attention to a committed and effective advocate for home care and/or hospice in the United States. These advocates for home care and hospice can provide important tips for everyone about how we can better persuade the public and our elected officials…

Florida Members of Congress Question CMS about Prior Authorization Program

In response to the Review Choice Demonstration (RCD) program, as proposed by the Centers for Medicare and Medicaid Services (CMS), members of the Florida Congressional Delegation have submitted a letter to CMS outlining their concerns with the program. The RCD program, a slightly modified version of 2016’s Pre-Claim Review (PCR) demonstration program, was proposed as…

NAHC to CMS: Suspend Review Choice Demonstration

The National Association for Home Care & Hospice (NAHC) has called upon the Centers for Medicare & Medicaid Services (CMS) to suspend implementation of the newly-proposed Review Choice Demonstration program because it will prove expensive to implement and no evidence exists that it will serve the goals of program integrity as well or better than…

CMS Releases FAQ about Revised Pre-Claim Review Proposal

As we reported last week, the Centers for Medicare & Medicaid Services (CMS) proposed to bring back an altered version of the pre-claim review (PCR) demonstration. The CMS released a list of frequently asked questions (FAQ) and answers about their proposal and they provide some insight into what is coming for the industry if the…

CMS Plans to Bring Back Pre-Claim Review

The Centers for Medicare & Medicaid Services (CMS) plans to bring back an altered version of the pre-claim review (PCR) demonstration that was halted at the end of March 2017 after it was revealed that it found mere paperwork errors instead of the fraud that it was intended to uncover, according to May 29 offer…

GAO Calls for CMS to Resume Prior Authorization Experiment

A new report from the Government Accountability Office (GAO) calls on the Centers for Medicare & Medicaid Services (CMS) to resume or extend prior authorization experiments that have either been halted or are due to end soon. CMS began using prior authorization programs in September 2012 to ensure Medicare coverage and payment rules were met…