Pre-Claim Review Demonstration for Home Health Services
Wednesday, July 20, 2016
The Centers for Medicare & Medicaid Services (CMS) will host a third Special Open Door Forum (ODF) call to allow home health agencies, physicians, and other interested parties to learn about the Pre-Claim Review Demonstration for Home Health Services. Two of CMS’ Medicare Administrative Contractors, Palmetto GBA and CGS, will be available for questions. Palmetto GBA will present on their activities to ready for the demonstration launch in Illinois, and provide an overview of their Web portal submission tool. Here is the link to Palmetto GBA’s portal: https://www.
CMS will be implementing a 3-year Medicare Pre-claim Review Demonstration for Home Health Services in the states of Illinois, Florida, and Texas by the end of 2016. CMS plans to include Michigan and Massachusetts in the demonstration in 2017. CMS is testing whether pre-claim review helps reduce expenditures, while maintaining or improving quality of care. Additionally, CMS believes the demonstration will also help assure services are provided in compliance with applicable Medicare coverage and payment rules, thereby assisting in the prevention of fraud, waste, and abuse. This demonstration should not delay care to Medicare beneficiaries and does not alter the Medicare home health benefit.
You can learn more about the Pre-Claim Review Demonstration for Home Health Services by going to: https://www.cms.gov/Research-
Statistics-Data-and-Systems/ Monitoring-Programs/Medicare- FFS-Compliance-Programs/Pre- Claim-Review-Initiatives/ Overview.html
Questions regarding the demonstration may be sent to: HHPreClaimDemo@cms.hhs.gov
Conference ID #: 17049475
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
A transcript and audio recording of this Special ODF will be posted to the Special Open Door Forum website for downloading at: http://www.cms.gov/
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