<img src="//bat.bing.com/action/0?ti=5565311&amp;Ver=2" height="0" width="0" style="display:none; visibility: hidden;">

Delta Connect Blog

Review Choice Demonstration Set to Begin September 30 in Ohio

Posted by Crystal Parks on Jul 29, 2019 5:11:25 PM

ChoicesToday, CMS announced the next state to participate in the Review Choice Demonstration (RCD) is Ohio beginning September 30, 2019.  CMS also stated it anticipates 60-90 days between beginning the demonstration in the remaining states of Texas, North Carolina, and Florida.

Medicare certified home health providers in Ohio will have from August 16 - September 15 to make their RCD choice selection via Palemetto GBA's eServices portal.  Since selections must be made through eServices, any Ohio provider not already signed up for eServices should do so now using the eServices portal link above. 

Ohio providers that do not make an RCD choice selection by September 15 will be automatically placed in Choice 2: Post-payment Review.

Home health providers will initially select between three review choices:

  • Choice 1: Pre-Claim Review,
  • Choice 2: Post-payment Review, or
  • Choice 3: Minimal review with a 25% payment reduction
    • Those who select this choice will remain in this choice for the duration of the demonstration regardless of their claim approval rate.

Home health providers who select either Choice 1 or Choice 2 will be evaluated for six months. If the providers full affirmation rate or claim approval for those six months is 90 percent or greater (based on a minimum of 10 submitted pre-claim review requests or claims), the provider may select one of the three subsequent review choices.

  • Choice 1: Pre-Claim Review,
  • Choice 4: Selective Post-payment Review, or
  • Choice 5: Spot Check Review

Home Health providers that do not actively choose one of the subsequent review option will automatically be assigned to participate in Choice 4: Selective Post-payment Review, and will remain there for the duration of the demonstration.

CMS has published a RCD HH Operational Guide that all providers affected by RCD should review.  There are also several other helpful resources for RCD available from Palmetto.  They are located at the Palmetto GBA Home Health Review Choice Demonstration webpage.

Read More

Topics: Regulatory Update, Review Choice Demonstration


Recent Delta Blogs