Home Health & Hospice Week

Newly revealed demonstration stats are likely to lead to an extension.

Keep an eye out for an extension of the Review Choice Demonstration — and that extension is likely to come with an expansion too.

The Centers for Medicare & Medicaid Services already has expanded RCD to Oklahoma effective Dec. 1, noted CMS’ Emily Richmond in the agency’s Oct. 11 Home Health Open Door Forum. It joins “the existing demonstration states of Illinois, Ohio, Texas, North Carolina and Florida,” Richmond reviewed.

Oklahoma home health agencies have from Oct. 16 to Nov. 15 to submit their RCD review option choices, Richmond added. They can choose pre-claim review, post payment review, or a “minimal post payment review with a 25 percent payment reduction, which means 100 percent of those claims have a 25 percent payment reduction,” she explained.

“All home health episodes of care beginning on or after Dec. 1 will be subject to the requirements of the review choice selected,” Richmond specified. Oklahoma HHAs that choose the PCR option can start submitting those requests on Dec. 1 as well, she noted.

One forum attendee hoped that CMS would be conducting some education with home health referral sources about the Oklahoma expansion. “Has there been any outreach to referral sources such as physician offices since this is a fairly new demonstration in the state of Oklahoma?” asked the provider.

A CMS official replied that the agency and RCD Medicare Administrative Contractor Palmetto GBA have been providing education for home health agencies in the state. But “physician offices are referral sources” and “agencies in Oklahoma will have to go back and forth with [them] to get documentation about the face-to-face visit,” the provider explained to CMS.