CMS Delays Review Choice in Texas, North Carolina & Florida

WASHINGTON, D.C. (October 30, 2019)—To allow home health agencies to transition to the Patient-Driven Groupings Model (PDGM), which becomes effective on Jan. 1, 2020, The Centers for Medicare & Medicaid Services (CMS) is rescheduling the implementation of the Home Health Review Choice Demonstration (RCD) for the remaining states of Texas, North Carolina and Florida. The demonstration is expected to begin in Texas on March 2, 2020. The choice selection period will begin on Jan. 15, 2020 and end on Feb. 13, 2020 for Home Health Agencies (HHAs) located in Texas, who submit claims to Palmetto GBA, the Jurisdiction M Medicare Administrative Contractor (MAC). 

HHAs should visit the Palmetto GBA provider portal for information and instructions on the RCD selection process. Through the portal, HHAs will be able to view the three initial review choices and make their selection. Palmetto GBA will also send letters to all Texas HHAs detailing this information. HHAs that do not make a choice selection by Feb. 13, 2020 will be automatically placed in Choice 2: Post-payment Review.

Following the close of the choice selection period, the demonstration is expected to begin in Texas on March 2, 2020, and all periods of care starting on or after this date will be subject to the requirements of the choice selected.

Following the start of the demonstration in Texas, the demonstration is expected to begin in North Carolina and Florida on May 4, 2020. CMS will monitor the transition to PDGM and assess the need for any change to this date.

With the transition to the PDGM, CMS will phase in the inclusion of Low Utilization Payment Adjustments (LUPAs) within the Review Choice Demonstration (RCD).

Visit cms.gov for more information and continued updates.