The Centers for Medicare and Medicaid Services (CMS) announced Friday that it was suspending the Pre-Claim Review Demonstration program (PCRD) that has been sharply criticized by the home health community. The Pre-Claim Review demonstration is paused for at least 30 days in Illinois and did not expand to Florida on April 1, 2017.
Since the start of PCRD in Illinois in August 2017, numerous members of Congress joined with NAHC and home health agencies in the five targeted states to express concerns with PCRD and its impact on care access and cost. Last Tuesday the new CMS Administrator Seema Verma met with several home health agency executives so she could hear first-hand about the difficulties with PCRD. The home health delegation conveyed that PCRD has found that the source of any “improper payments” is limited to documentation deficiencies. The delegation committed to partner with CMS to develop and institute more effective and efficient solutions to correct any paperwork errors.
The National Association for Home Care and Hospice (NAHC) will continue to work to improve some of the unmanageable documentation policies, particularly the face-to-face requirements, which are the root cause of much of the findings of “noncompliance.” In that regard, CMS has opened up the lines of communication to consider policy changes. Additionally, F2F reform legislation will be introduced as early as this week.
MHCA will continue to communicate our concerns with the Minnesota congressional delegation and encourages members to do the same.
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