Out of limbo: Review Choice approved

What’s in your mailbox? Illinois home care providers can expect letters announcing new launch date

Home care providers in Illinois can expect to receive letters soon from the Centers for Medicare and Medicaid (CMS) announcing a new start date for the Review Choice demonstration.

Originally expected to begin Dec. 10, 2018, the Review Choice demonstration has been on hold for months now, awaiting final approval from the Office of Management and Budget required under the federal Paperwork Reduction Act. The federal law requires OMB authorization for the collection of certain types of information.

“OMB has finally given its approval this week for the demonstration to go forward, but CMS has not yet announced the new start date,” said J’non Griffin, owner and president of Home Health Solutions. “We’re expecting an announcement from CMS at any time now, and it is likely that the demonstration will get underway in the next few weeks. The CMS announcement will appear on the web site, so providers should keep watch for the official launch date."

Details about the launch with specific instructions will be provided by mail. CMS has previously said agencies can expect to be notified by letter about the official start date for Review Choice, and that letters will detail options and instructions for making choices. Options made available to agencies in Illinois will be based on their affirmation rates during the pre-claim review (PCR) demonstration which operated in that state from August 2016 through the end of March 2017.

Agencies which experienced fewer issues under the 2016-17 PCR demonstration in Illinois are expected to be eligible for more review options than other agencies. All agencies will be allowed to choose whether they prefer pre-claim reviews or post-claim reviews.

“One of the top questions home care agencies have as the Review Choice demonstration gears up again is how much time they will have to review their options and make a decision about which review option to select,” J’non said. “We expect the answer to be a few weeks. During an educational call about Review Choice last fall, CMS representatives assured home care providers that they would have a minimum of two weeks in which to make that decision after the agency receives its official letter.” Illinois is the first of five states targeted for the Review Choice demonstration. CMS has previously agencies in the other four states -- Ohio, North Carolina, Florida and Texas – will be notified via an announcement on the CMS web site prior to being phased into the demonstration. The announcement is expected to be made at least 60 days in advance of the rollout in those states. CMS has also said additional states may be added to the demonstration.