CMS Urged Not to Re-implement HH Demonstration as Proposed

AHA today urged the Centers for Medicare & Medicaid Services not to re-implement a home health demonstration as proposed. The agency in May issued a notice proposing to revise and expand to other states a HH claim review demonstration paused last year in Illinois following broad opposition to its design. The proposed Review Choice demonstration would begin on or after Oct. 1 in Illinois, Ohio, North Carolina, Florida and Texas, with the option to expand to other states. Participants would have the options of 100% pre-claim review, 100% post-payment review, or a 25% payment reduction on all HH claims, which would still be eligible for review by recovery audit contractors. AHA said the proposed demonstration would reduce beneficiary access to care, penalize providers with no history of fraud, and run counter to CMS’s other HH reform efforts.