Posted Monday, December 14, 2020

Up until now, in the RCD states, if an agency was under another demonstration (like TPE) they would remain and be excluded from others, because providers cannot be under Targeted Probe and Education (TPE) and the Review Choice Demonstration (RCD) at the same time. Providers who were on TPE review in the states of Illinois, Ohio, Texas, North Carolina and Florida have been removed from TPE review and will not receive Additional Documentation Requests (ADRs) related to that review.  CMS’ most recent update for home health agencies in the five Review Choice Demonstration (RCD) states may put administrators at ease; however, it’s important to understand what’s underneath this change. With this new change, CMS is telling agencies in these states they want to see the documentation up front instead of cherry picked at the end.

Thus far, RCD has been a successful demonstration and allows agencies an opportunity to make corrections in real time and as needed. Once through the initial learning curve of how the demonstration works, the process smooths out and provides agencies the knowledge that the conditions of participation and/or billing requirements have been met. This also ensures that the agency will not be subjected to TPE projects from their intermediary. Agencies may still receive requests for ADR, but they can rest assured that all of the initial documentation meets all regulations.

Corridor’s team of seasoned home health regulatory experts are here to help you. To learn more about our Review Choice Demonstration support services, click here.

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