CMS Provides Feedback on Pre-Claim Review with FAQs

Posted on Monday, April 10, 2017 12:43 PM

The Centers for Medicare and Medicaid Services (CMS) released several Frequently Asked Questions (FAQs) concerning the status of its pre-claim review (PCR) demonstration program.

On March 31, 2017, CMS announced that the PCR would be put on hold in Illinois and delayed in Florida.

This decision was made after NAHC and other home health agency executives met with the new CMS Administrator Seema Verma. Verma requested the meeting to discuss the difficulties with the PCR demonstration.

The FAQs provide the following guidance:
• No further submissions to PCR in Illinois are required
• Pending PCRs will be completed
• Resubmissions of rejected submissions will not be accepted

Effectively, home health agencies in Illinois return to the claim process followed prior to the demonstration project that began in August 2016.

To see the direct link for the Demonstration Pause Q&A, click here.

NAHC will continue to work with CMS to develop alternatives to the pre-claim review demonstration.

For the full article, click here.

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