BREAKING NEWS: CMS to implement "Pre-Claim Review"

In a shocking move, the Centers for Medicare and Medicaid Services is pushing forward with the well-debated Prior Authorization requirement for Home Health agencies in providing in-home health services to Medicare and Medicaid beneficiaries. This demonstration will take effect for certain states for 3 years.

Click here for the notice to action.

The states that are included in the Pre-Claim Review Demonstration are as follows:

  1. Illinois (starts August 1, 2016)
  2. Florida (starts October 1, 2016)
  3. Texas (starts December 1, 2016)
  4. Michigan (starts January 1, 2017)
  5. Massachusetts (starts January 1, 2017)

Amid the disagreement by the industry, beneficiaries, and many others, there must be light at the end of the tunnel as this program is tested – clarity for all concerned whether it will work or not.

News source: Home Health Care News