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Review Choice Demonstration

The Review Choice Demonstration continues for Medicare home health services in selected states–specifically, Illinois, Ohio, Texas, Florida, and North Carolina.  Here’s some of the latest news of RCD: Due to the lingering public health emergency, CMS has extended the phased-in participation for Florida and North Carolina until July 31, 2021.  This allows the agencies in…

The Review Choice Demonstration continues for Medicare home health services in selected states–specifically, Illinois, Ohio, Texas, Florida, and North Carolina.  Here’s some of the latest news of RCD:

  • Due to the lingering public health emergency, CMS has extended the phased-in participation for Florida and North Carolina until July 31, 2021.  This allows the agencies in those states to make a choice of whether or not to submit pre-claim review requests without penalty.  However, the claims of unsubmitted records may be subject to postpayment review in the future.
  • Eligible agencies  in Illinois and Texas have until July 16, 2021 to make their next cycle review selections.  Failure to make a selection will default to a Postpayment Review (Choice 2 or Choice 4) depending on the agency’s eligibility status.
  • The proposed final rule for home health was published this week and there was no mention of expansion of the Review Choice Demonstration to the remaining 45 states.  However, in case you hadn’t heard, Value-Based Purchasing for home health is proposed to expand nationwide on January 1, 2022.