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News and Press: News & Views

CMS Delays Review Choice Demonstration Enforcement 60 Days

Friday, August 21, 2020   (0 Comments)
Posted by: Kyle Simon

Today the Centers for Medicare & Medicaid Services (CMS) announced a delayed phase-in of the Review Choice Demonstration (RCD) for Florida and North Carolina, which was set to begin on August 31, 2020.

Specifically, for home health agencies in Florida and North Carolina:

  • Providers may submit pre-claim review requests for billing periods beginning August 31, 2020. During this transition period a provider does not have to request pre-claim review for each and every claim (if they want to participate in pre-claim review), only those they choose to submit.
    • Claims that go through pre-claim review and are submitted with a valid Unique Tracking Number (UTN) will be excluded from further medical review.
  • Claims submitted without going through the pre-claim review process will process as normal and will not be subject to a 25 percent payment reduction.
    • Claims may be subject to post-payment review in the future through the normal medical review process.
  • Providers who have already made a choice selection do not need to take any further action if they choose not to participate.
  • CMS will reassess the phased-in approach in 60 days.

Over the past month, providers like you have answered our calls to contact CMS and members of Congress, and you really knocked it out of the park by inundating their inboxes with over 11,500 emails! During these challenging times, a delay of any kind is significant and necessary, and this victory could not have been possible without your unified voices and advocacy.

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