CMS to launch home health claim-review project Dec. 10
The Centers for Medicare & Medicaid Services its revised claim-review demonstration for Medicare fee-for-service home health services beginning Dec. 10 in Illinois. The five-year project will eventually expand to include providers in Ohio, North Carolina, Florida and Texas, with the agency expected to provide 30 days鈥� advance notice. As proposed in May, providers in the demonstration states can choose to participate in either 100 percent pre-claim review or 100 percent post-payment review; those that do not participate will receive a 25 percent payment reduction on all HH claims and may be eligible for review by Recovery Audit Contractors. For more information, visit . CMS introduced a similar demonstration in 2016 in Illinois, but paused it last April due to broad opposition. In comments submitted to the agency in July, AHA said that re-implementing the demonstration as proposed would reduce beneficiary access to care, penalize providers with no history of fraud, and run counter to CMS鈥檚 other HH reform efforts.