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CMS Extends Review Choice Demonstration (RCD) for 5 More Years

    The Centers for Medicare and Medicaid Services (CMS) announced the extension of the Review Choice Demonstration (RCD) for five more years effective June 1, 2024. RCD will continue in the current demonstration states of Illinois, Ohio, Texas, North Carolina, Florida, and Oklahoma.

    Removal of Choice 3: Minimal Review with 25% Payment Reduction

    The Review Choice Demonstration (RCD) offers home health agencies options for claims review as long as they remain compliant after each round. With the RCD extension, CMS announced the removal of Choice 3: Minimal Review with 25% Payment Reduction from the initial selection options. Agencies previously using this option must now choose between the two remaining initial review options: Pre-Claim Review or Postpayment Review. The timeline for this selection is as follows:

    • Choice selection period start date: June 17, 2024
    • Choice selection period end date: July 1, 2024
    • Cycle effective date: July 15, 2024

    Palmetto GBA will proactively coordinate with the small number of affected providers to help them select a new review choice. Providers who do not make an initial selection will automatically default to Choice 2: Postpayment Review. Additionally, providers with fewer than 10 reviews at the end of the current cycle will have their results carried over to the next cycle.

    Further Guidance

    It has also been confirmed that Ohio and Florida will continue their current cycles until June 30, 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 31. The new selection period for Oklahoma will be from July 1 to July 15, with the new cycle beginning on August 1.

    RCD is managed solely by Palmetto GBA, the Medicare Administrative Contractor (MAC). Home health agencies experiencing challenges with their current review choice selection and want to change it, must notify Palmetto by June 14, 2024, to ensure their selection is updated.

    The extension could suggest that more states will likely be added to the Review Choice Demonstration in the future, and it may even expand to other MACs. Therefore, agencies in states not currently participating in the demonstration are advised to familiarize themselves with how the RCD works to prepare for potential expansion.