On May 31, 2018, CMS published a notice indicating its intention to re-launch a previously abandoned home health demonstration project, but with some modifications. CMS proposes that the new demonstration project would initially be implemented in Illinois, Ohio, North Carolina, Florida and Texas, with the option to expand to other states in the Palmetto/JM jurisdiction. Home health agencies would be able to select one of the following three options: (1) participate in a 100% pre-claim review; (2) participate in a 100% post-payment review; or (3) participate in neither but incur a 25% payment reduction on all claims for home health services with the potential for review by Recovery Audit Contractors. For providers selecting either of the first two options, once the home health agency reaches the target pre-claim review affirmation or post-payment review claim approval rate, the home health agency would be able to choose to be relieved from claims reviews, except for periodic checks of their claims to ensure continued compliance. A similar program was paused in 2017 following concerns raised by the home health industry. Comments on the proposed demonstration project must be received by July 30, 2018.

To view the notice in the Federal Register, click here.