News Briefs: June 4, 2018

By Nina Youngstrom

◆ CMS is taking another stab at prepayment reviews of home health care claims. In a May 31 Federal Register notice, CMS proposed a demonstration, initially in Illinois, Ohio, North Carolina, Florida, and Texas, and home health providers could pick either “pre-claim or postpayment review.” Prepayment reviews piloted in five states in 2016 didn’t go so well and were dropped. “This proposal leads to many more questions than answers,” says Ronald Hirsch, M.D., vice president of regulations and education for R1 RCM. “Why was this proposed now? Were there widespread errors found in the targeted probe and educate audits that led CMS to feel that fraud was still occurring on a widespread basis? Did HHA error rates not improve after multiple probe audits?” Visit https://tinyurl.com/y74u63nq.

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