BREAKING NEWS – Home Health Review Choice Demonstration Extended 5 Years

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Today the Centers for Medicare & Medicaid Services (CMS) posted a notice on the Home Health Review Choice Demonstration (RCD) webpage announcing that the demonstration is being extended for five years.  The demonstration was scheduled to end on May 31, 2024, and the extension is not a surprise. States currently in the demonstration – Illinois, Ohio, […]

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North Carolina, Florida Home Health Agencies to See Changes in Review Choice Demonstration

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The Centers for Medicare & Medicaid Services (CMS) announced this week that for home health providers subject to the Review Choice Demonstration (RCD) in North Carolina and Florida, the 25 percent payment reduction will be implemented for all claims submitted on or after April 1, 2022. This applies to home health agencies that selected Choice […]

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CMS Revises Review Choice Demonstration for North Carolina and Florida

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Another big win for NAHC Advocacy! The Centers for Medicare & Medicaid Services announced Thursday, August 26, it is modifying the Review Choice Demonstration (RCD) in Florida and North Carolina, so that only those claims with dates of service beginning on and after September 1, 2021 will be subject to additional development request (ADR)/prepayment review if […]

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Review Choice Demonstration to be Fully Implemented in North Carolina, Florida

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  Effective September 1, 2021, home health providers in North Carolina and Florida will see full implementation of the Review Choice Demonstration (RCD). RCD was originally scheduled to begin in the two states on May 4, 2020, but was delayed by the COVID-19 Public Health Emergency. Instead, a phased-in approach began in August 2020 allowing […]

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RCD Phase-in for Florida and North Carolina Renewed

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The Centers for Medicare & Medicaid Services (CMS) announced a continuation of the phased-in participation of the Review Choice Demonstration (RCD) for home health agencies (HHAs) in Florida and North Carolina for an additional 90 days, due to the ongoing COVID-19 PHE. Providers interested in participating should make their Cycle 2 Choice selections between April […]

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CMS Extends Phased-in Review Choice Demonstraton in Florida & N. Carolina

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The Centers for Medicare & Medicaid Services (CMS) announced on Thursday night, October 29, that due to the continuing public health emergency, CMS will be extending the phased-in participation in the Review Choice Demonstration (RCD) for Home Health Agencies in Florida and North Carolina until January 1, 2021. Providers may continue submitting pre-claim review requests. Claims […]

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Florida Reps Urge CMS to Delay Review Choice Demonstration in Florida

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A trio of Representatives from Florida have sent a letter to the Centers for Medicare and Medicaid Services (CMS) expressing concerns with the decision to move forward with the Review Choice Demonstration (RCD) program in Florida. In March, due to the burgeoning COVID-19 pandemic, CMS announced that the RCD program would be paused from expansion […]

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Hospice PEPPER Available & Key CMS Updates for Hospice & Home Care in New Open Door Forum

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Hospice PEPPER Available The Hospice PEPPER (Program for Evaluating Payment Patterns Electronic Report) is now available. PEPPER is a data report that contains a single hospice’s claims data statistics (obtained from the UB-04 claims submitted to the Medicare Administrative Contractor (MAC)) for areas targeted by CMS as being at risk for improper Medicare payment. Each […]

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CMS To Resume Medical Review Activities, Including Review Choice Demonstration

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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 […]

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CMS Announces Return of Review Choice Demonstration in Early August

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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 […]

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CMS Issues New Waivers under the Conditions of Participation

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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 […]

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

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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 […]

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