Home care
CMS moves to add California to home health claims review as enrollment freeze nears Nov. 13 end
Medicare filed a notice to expand its home health Review Choice Demonstration to California. Separately, the national freeze on new hospice and home health agencies is set to lapse November 13 unless CMS extends it.
Key facts
- CMS notice to expand claims review to California.
- Hospice and home health enrollment freeze set to end Nov. 13.
- Current patients' care is not affected.
What happened
The Centers for Medicare & Medicaid Services filed a notice on Friday, October 30, asking the Office of Management and Budget for expedited approval to revise its home health Review Choice Demonstration, a step toward expanding it to California, Home Health Care News reported. The demonstration, which adds closer review of Medicare home health claims, already runs in Illinois, Ohio, Oklahoma, North Carolina, Florida and Texas. The notice is scheduled for Federal Register publication on November 2, with a 14-day comment period.
Separately, the nationwide moratorium that has blocked new hospice and home health agencies from enrolling in Medicare since May 13 is set to expire November 13. As of October 30, no extension notice had been published. A CMS official said at an industry meeting on October 28 that any extension would have to run six months.
The freeze does not affect agencies already enrolled in Medicare and does not stop care for anyone currently receiving services. Agencies that pass reviews at high rates can earn relief from most claims reviews.
What it means for families
If your parent already gets Medicare home health or hospice, nothing changes for their care. Families looking for a new agency should choose from agencies already enrolled in Medicare.
New York is not part of the review demonstration.
Whether new agencies can enroll after November 13 depends on CMS's decision.
Families can compare agency quality ratings on Medicare's Care Compare.
New York is not among the review demonstration states. New Yorkers seeking home health care after a hospital or rehab stay can ask discharge planners for a list of Medicare-certified agencies serving their county and compare them on Care Compare.
What to do this week
- Confirm a home health agency is Medicare-certified before starting.
- Ask the discharge planner for several agency options.
- Report suspected Medicare fraud to 1-800-MEDICARE.
Sources
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