CMS To Resume Medical Review Activities, Including Review Choice Demonstration

The Centers for Medicare & Medicaid Services (CMS) has announced the return of medical review activities, including the Review Choice Demonstration (RCD) program for home health services on August 3, 2020, regardless of the status of the Public Health Emergency (PHE). On March 30 the Centers for Medicare & Medicaid Services (CMS) suspended most Medicare…

NAHC Asks CMS/HHS for Reg Flexibility to Fight COVID-19

The National Association for Home Care & Hospice (NAHC) has made a series of requests to the Centers for Medicare & Medicaid Services (CMS) for regulatory action designed to enable home health and hospice to fulfill its potential as the health care setting most suited to stopping the spread of the novel coronavirus COVID-19 while…

CMS Issues New Waivers under the Conditions of Participation

The Centers for Medicare & Medicaid Services (CMS) has waived some significant provisions of the home health Conditions of Participation. The following items under the CoP have been waived by CMS. The initial evaluation under 484.55 (a) will not require an on-site visit and may be conducted remotely or through medical review. This does not…

Open Door Forum Summary: Updates on iQIES Transition Update and Home Health & Hospice

The Centers for Medicare & Medicaid Services (CMS) held a Home Health, Hospice, & DME Open Door Forum (ODF) on January 8, 2020.  A summary is provided below, beginning with home health and followed by hospice. HOME HEALTH iQIES Transition CMS indicated in the ODF that it is aware of several issues with the iQIES…

CMS Updates Review Choice Demonstration FAQs to Address PDGM

The Centers for Medicare & Medicaid Services (CMS) has updated the Frequently Asked Questions (FAQs) and the Operational Guide for the Review Choice Demonstration(RCD)to include additional information on how the Patient-Driven Groupings Model (PDGM) will affect the demonstration. CMS updated the Operational Guide in early December  to include instructions for submitting documentation relate to PDGM,…

Important Information for all HHA in Review Choice Demonstration under PDGM

For those home health agencies that are part of the Review Choice Demonstration and have selected the Pre-claim Review (PCR) option, the long awaited CMS update confirming that HHAs will need to submit a PCR for each 30-day billing period has been posted.  CMS updated the RCD Operational Guide, Chapter 6, with the following: For…

Implementation of Review Choice Demonstration Delayed

The National Association for Home Care & Hospice (NAHC) has been urging the Centers for Medicare & Medicaid Services (CMS) for months to delay implementation of the Review Choice Demonstration, as it is our view that to implement RCD in December 2019 in Texas and then the Patient Driven Groupings Model only weeks later, would…

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…