Review Choice Demonstration (RCD) to Resume

Who:
Home Health providers in the states of Illinois, Ohio, Texas, North Carolina and Florida.

What:
CMS will restart the Review Choice Demonstration (RCD) following the pause for COVID-19. Home Health claims in all demonstration states with billing periods on or after August 31, 2020, will be subject to review under the requirements of the choice selected. Palmetto GBA will conduct postpayment review on claims subject to the demonstration that were submitted and paid during the pause.

When:

• August 3, 2020 - August 17, 2020: Initial Choice Selection period for North Carolina and Florida. The selection period will start on August 3, 2020 and end on August 17, 2020. Selections are made on the RCD dashboard in eServices. You do not need to take any additional steps if you have already made your selection.
• August 3, 2020 - August 17, 2020: Cycle 2 selection period for Ohio. The selection period will start on August 3, 2020 and end on August 17, 2020. Selections are made on the RCD dashboard in eServices. You do not need to take any additional steps if you have already made your selection.
• August 31, 2020: Home Health claims in all demonstration states (Illinois, Ohio, Texas, North Carolina and Florida) submitted to Palmetto GBA with a billing period start date on or after August 31, 2020, will be subject to the demonstration.

Please note:
If your choice selection was PCR prior to the RCD pause, please note the following:

• Billing periods starting on or before August 30, 2020:
  • You may submit a PCR request.
  • If a PCR request was submitted, the claim must be submitted with the UTN.
  • If no PCR request was submitted, the claim will process for payment.  Post payment review of the claim will be conducted at a later date.
• Billing periods starting on or after August 31, 2020:
  • You may submit a PCR request.
  • If a PCR request was submitted, the claim must be submitted with the UTN.
  • If no PCR request was submitted, the claim will suspend, and you will receive a pre-payment ADR.a

If your choice selection was a postpayment or spot check review prior to the RCD pause, you will begin receiving ADRs for billing periods starting on or after August 31, 2020.

Find answers to your questions by visiting the Provider Burden Relief FAQs (PDF, 54 KB) or by visiting the CMS webpage for the RCD.