CMS Makes Home Health Major Announcements: CoP Delay, Pre-Claim Review Pause and Delay

 In Home Health, Industry News, News, Regulatory

Over the past two days, the Centers for Medicare and Medicaid Services (CMS) made two major surprise announcements for Home Health Regarding the New Conditions of Participation and the Pre-Claim Review Demonstration.

Delay in New 2017 Home Health Conditions of Participation

On March 30, 2017, the Department of Health and Human Services posted an update regarding Medicare and Medicaid Programs Conditions of Participation (CoP’s) for Home Health Agencies. The update includes a Proposed Rule that would delay the new CoP’s for six months, moving the effective date from July 13, 2017 to January 13, 2018. This Proposed Rule is subject to a 60-day public comment period, followed by publication in the Federal Register, which is scheduled for April 3rd.

Pre-Claim Review Demonstration Paused in Illinois, Delayed in Florida

The controversial Home Health Pre-Claim Review demonstration will be paused in Illinois and will not expand to Florida on April 1, as planned.  In a brief post on the CMS website, it was stated:

“As of April 1, 2017, the Pre-Claim Review demonstration will be paused for at least 30 days in Illinois. The demonstration will not expand to Florida on April 1, 2017.

After March 31, 2017, and continuing throughout the pause, the Medicare Administrative Contractors will not accept any Pre-Claim Review requests.  During the pause, home health claims can be submitted for payment and will be paid under normal claim processing rules. CMS will notify providers at least 30 days in advance via an update to this website of further developments related to the demonstration.”

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