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Home Health Industry Can’t Fight CMS’ New Pre-Claim Review Initiative, RCD

Posted on Tuesday, October 16, 2018 6:46 PM

CMS, in its effort to combat improper billing, is moving forward with the pre-claim review initiative, now named Home Health Review Choice Demonstration (RCD), despite opposition from the industry. 

RCD enables home health agencies to waive prior claims authorization in favor of post-payment review. In post-payment review, providers would verify claims after they had already received payment, allowing CMS to rescind funds if any overpayment is discovered. Another provision of RCD is to allow home health providers to opt out of pre and post-payment review for a 25% reduction on all payments for claims submitted.

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