The Homecare & Hospice Community Continue Efforts to Repeal Pre-Claim Review

Posted on Wednesday, November 9, 2016 8:02 PM

With the failed pre-claim review (PCR) demonstration in Illinois, concern remains constant throughout the country that the program will continue to spread.

PCR was “likely to create improper barriers to access to timely care,” NAHC wrote in a July 2016 letter to the Office of Management and Budget (OMB), encouraging that PCR be withdrawn before it even started. Shortly after PCR began, NAHC Vice President for Law William Dombi named PCR “a complete mess. That is the result we all predicted, given the magnitude of the undertaking that increased the MAC’s claim review workload 40-50 times of its normal volume.”

NAHC’s continued efforts to end PCR led them to seek help from members of Congress, urging them to see the problems of PCR and the damage it has done to patients and agencies in Illinois.

Those efforts assisted in a temporary hold for the rest of the country, but it is essential that PCR comes to an end in Illinois and will not be exposed to the rest of America. With that being said, at NAHC’s annual meeting in Orlando, FL, Chair of the NAHC Board of Directors Denise Schrader and NAHC President Val Halamandaris announced that a lawsuit would be filed against the Centers for Medicare and Medicaid Services (CMS) to stop pre-claim review.

As regulations are forced on the homecare and hospice community, the fight against pre-claim review continues. NAHC wants to direct our attention Report to a piece published in RealClearHealth, written by Kyle Simon, Director of Government Affairs and Communications at the Home Care Association of Florida.

For the full piece, click here.

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