The Review Choice Demonstration, a program that offers home health agencies several options for claim reviews, has been extended for another five years. This demonstration, managed by the Medicare Administrative Contractor Palmetto GBA, is currently in effect in five states.

The Review Choice Demonstration offers several options for agencies, provided they remain compliant after each round. One option included a minimal chart review, meaning only a few charts would be examined, but it came with a 25% payment reduction. This option is now being eliminated. Agencies previously using this option must choose a new one between June 17th and July 1st.

Additionally, it has been confirmed that Ohio and Florida will continue their current cycles until June 30th, with a new selection period starting in August. Oklahoma, the most recent state added to the Review Choice Demonstration, will complete its current cycle on May 31st, with the new selection period occurring in July and a new cycle beginning on August 1st.

More details will be provided as Palmetto navigates the specifics. We believe this extension indicates that more states will likely be added to the Review Choice Demonstration, and it may even expand to other Medicare MACs. While this isn’t confirmed, it seems probable. Therefore, those not currently under the Review Choice Demonstration should prepare for potential expansion during this five-year extension.

Achieving affirmations on the first submission under the pre-claim review option of the RCD is crucial. Should you need assistance, please reach out to us.

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