Courtesy of the National Association for Home Care & Hospice (NAHC)

The Centers for Medicare & Medicaid Services (CMS) announced this week that for home health providers subject to the Review Choice Demonstration (RCD) in Florida and North Carolina, the 25% payment reduction will be implemented for all claims submitted on or after April 1, 2022. This applies to home health agencies that selected Choice 3 (minimal review with 25% payment reduction) or Choice 1 (pre-claim review, or PCR).

Any claims subject to PCR that are submitted without a PCR decision will be subject to the 25% payment reduction.

Full implementation of RCD in Florida and North Carolina began on September 1, 2021, and CMS intended to apply the 25% reduction at that time. After outreach by NAHC, the Home Care Association of Florida, and the Association for Home & Hospice Care of North Carolina, CMS pulled back on the 25% reduction and indicated it would not be applied for at least a period of 90 days from the full implementation date.

Click here to access RCD resources, education, and more information for providers.