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NAHC Pushes OMB and CMS to Back Off Review Choice Demonstration

Posted on Wednesday, November 21, 2018 4:34 PM

Last week, CMS released information detailing a reduction in improper payments through the Comprehensive Error Rate Testing (CERT) program.  The 2018 CERT results show a continuing and significant decline in ‘improper payments” in Medicare home health, down from nearly 59 percent just a few years ago to 17 percent in 2018.  As a result of this, NAHC is asking CMS and OMB to stop the planned RCD before it begins. 

The rapid and precipitous decline in overall “improper payments” in home health is due to fixing easily correctable documentation errors and is not related to benefit eligibility, says NAHC President William A. Dombi. “It is clear home health agencies have figured out what documentation is required to support valid Medicare claims. While the ‘improper payment’ rate is down dramatically, Medicare coverage of home health services has not declined. We believe recent improvements in documentation requirements by CMS that will take effect on January 1 will bring even better results in 2019.”

This decline in home health “improper payments” shows that CMS’ proposed $400 million Review Choice Demonstration is simply not needed. RCD will be expensive, burdensome, and will not accomplish anything that is not already happening.

Source: NAHC Report

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