CMS is now proposing a Dec. 10 launch date for its review choice demonstration in Illinois. And CMS also has announced a second opportunity for the home health industry to comment about the proposed demonstration.
 
The demo is planned for five states under the jurisdiction of Medicare Administrative Contractor (MAC) Palmetto GBA: Florida, Illinois, Ohio, North Carolina and Texas.
 
It ultimately might expand to all agencies within Palmetto’s 16-state jurisdiction.
 
Agencies will have 30 days to comment about the proposed demo. The comment period begins when CMS’ notice is published in the Federal Register on Sept. 27.
 
In an initial comment period, 480 industry stakeholders submitted comments — and most resoundingly opposed the demo (HHL 8/6/18). The commenters contended, among other things, that the demo would adversely impact compliant agencies and lead to administrative burdens that negatively affect patients.
 
Under the demo, agencies would choose whether to have 100% pre-payment or 100% post-payment reviews (HHL 6/11/18). Agencies also would have the ability to decide not to participate in either type of review and still offer services and submit claims. But those agencies would receive a 25% payment reduction on all claims submitted and may be eligible for review by the recovery auditor (RAC).
 
CMS initially said the five-year demo would occur no sooner than Oct. 1, though last month officials announced it would not launch until at least December (HHL 9/24/18). 
 
Related links: Read more about the review choice demo at https://go.cms.gov/2Of15oN. View CMS’ latest notice at https://bit.ly/2R2LJlI. Submit comments to the Office of Management and Budget (OMB), Office of Information and Regulatory Affairs, Attention: CMS Desk Officer, fax number: (202) 395-5806 or e-mail: OIRA_submission@omb.eop.gov.