CMS Announces Return of Review Choice Demonstration in Early August

July 8, 2020

• NAHC will have more information and analysis of this important event in tomorrow’s NAHC Report.

The Centers for Medicare & Medicaid Services (CMS) has announced the return of the Review Choice Demonstration (RCD) program for home health services on August 3, 2020, regardless of the status of the Public Health Emergency (PHE).

CMS paused the RCD program in Ohio, Illinois, and Texas on March 30, 2020, due to the impact of the novel coronavirus COVID-19, a move NAHC supported. In addition, RCD was scheduled to begin in North Carolina and Florida on May 4, 2020 and that was also delayed. According to CMS, the RCD pause would last “until the Public Health Emergency for the COIVD-19 pandemic has ended.”

“The initial choice selection period will begin in North Carolina and Florida on August 3, 2020 and end on August 17, 2020,” reads a July 7 post on the CMS website. “The choice selection period for Ohio’s second review cycle will also begin August 3, 2020 and end on August 17, 2020.”

CMS goes on to note that “home health claims in all demonstration states (Illinois, Ohio, Texas, North Carolina, and Florida) with billing periods beginning on or after August 31, 2020 will be subject to review under the requirements of the choice selected.  This includes pre-claim review, prepayment review, and postpayment review.”

It should be noted that some of the states slated to see a resumption of RCD, such as Florida and Texas, are currently undergoing severe increases in their coronavirus infection rates.

“Following the resumption of the demonstration,” writes the CMS, “the MAC will conduct postpayment review on claims subject to the demonstration that were submitted and paid during the pause.  CMS will post more information on the postpayment review process in the near future.”

Please see Provider Burden Relief Frequently Asked Questions (PDF) for more information.