REVIEW CHOICE DEMONSTRATION – Your agency still has time to choose!

Sharon Hamilton MS, RN, NLCPC, CFDS
Clinical Consultant – Briggs Healthcare

CMS is implementing a five-year Review Choice Demonstration (RCD) for Home Health Services in the states of Illinois, Ohio, Texas, North Carolina, and Florida beginning in 2019. The choice selection period for Home Health Agencies (HHAs) located in Illinois will begin on April 17, 2019 and end on May 16, 2019. HHAs who choose pre-claim review can begin submitting pre-claim review requests beginning June 1, 2019.

HHAs will initially select between three review choices:

  • Choice 1: Pre-Claim Review,
  • Choice 2: Post-payment Review, or
  • Choice 3: Minimal review with a 25% payment reduction. (HHAs that select this choice will remain in this choice for the duration of the demonstration regardless of their claim approval rate).

HHA will have until two weeks prior to the start of the demonstration in their state to make their choice selection. HHAs can make their selection by utilizing the Palmetto GBA eServices online provider portal at https://www.onlineproviderservices.com/ecx_improvev2/initLogin.do

HHAs who do not actively select one of the initial three review choices will be automatically assigned to participate in Choice 2: Post-payment Review.

Implementation dates for Ohio, Texas, North Carolina, and Florida have not been determined. To learn more and review the RCD Operational Guide go to the CMS and/or  Palmetto GBA  websites.