Home Health & Hospice Week

If you’re a home health agency in a Review Choice Demonstration state and also undergoing a UPIC review, your RCD contractor is trying to clear up some confusion for you.

How it works: While an RCD provider “is under review by a Unified Program Integrity Contractor (UPIC), they are excluded from the RCD program,” MAC Palmetto GBA explains in a new post to its website. “Providers under choice 1 (PCR) will receive a message stating that they are under a UPIC if they attempt to request a UTN and providers under an ADR option will stop receiving ADRs from Palmetto GBA,” the MAC specifies.

What’s next? “Once a UPIC review ends, the provider will receive a letter from the UPIC to confirm the date that the review ended. If the review ends in the middle of a cycle, the provider is excluded from RCD until the next cycle begins,” Palmetto clarifies.

For example: If a UPIC review ends on March 5 and the next cycle begins on April 1, the provider is excluded from RCD from March 5 – March 31, Palmetto explains. The provider will participate in RCD beginning April 1, it continues.

Tip: “Providers are expected to make a choice selection for an upcoming cycle while they are actively under a UPIC review,” Palmetto reminds HHAs. “This way, if their UPIC ends after the selection period but before the beginning of the next cycle, their selection has already been made and they can move back into the RCD program without further delay.”

More details are in the post at www.palmettogba.com/palmetto/jmhhh.nsf/DID/0ODR4CI266.