Review Choice Demonstration to be Fully Implemented in North Carolina and Florida

Posted Sunday, August 8, 2021

Starting on September 1, 2021, RCD is going live in North Carolina and Florida after a 16 month delay due to the pandemic.

North Carolina and Florida will have an additional mid-cycle selection period, as detailed below:

  • Selection Period Start Date: August 1, 2021
  • Selection Period End Date: August 15, 2021
  • New Selection Effective Date: September 1, 2021

Providers who made a selection during the first selection period for Cycle 2 in April and wish to remain in the same option they previously selected do not need to take any action.

Providers who previously made a selection for Cycle 2 in April and wish to change their selection will have the ability to do so during the mid-cycle selection period. The RCD Choices available to these providers will be based on their Cycle 1 results.

Providers who did not previously make a selection for Cycle 2 and do not make a selection during this mid-cycle selection period will default to either Choice 2 (Postpayment Review) or Choice 4 (Selective Postpayment Review) based on their Cycle 1 results.

Cycle 2 for NC and FL will end on October 31, 2021.

CMS also announced that all claims with dates of service on or after August 31, 2020, that are submitted on or after September 1, 2021, without a PCR decision on file will be pulled for pre-payment review. This means every agency will have to be at 100% submission by September 1, 2021. If not it could be dealing with tens, hundreds or thousands of ADRs. If you are a provider in NC or FL, we urge you to act now and contact your state association.

As the preferred RCD partner, Corridor has successfully helped HHAs achieve a 99% affirmation rate while under 100% pre-claim review resulting in the organization being able to switch to a 5% spot check.

If you are impacted by RCD, click here or call Corridor today at 1-866-263-3795.

Source: NAHC

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