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Author: Alora Home Health Software

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 RCD Implementation Update

In the latest homecare news, the Centers for Medicare & Medicaid Services (CMS) will delay the implementation of Review Choice Demonstration (RCD) so agencies have adequate time to adapt to the upcoming Patient-Driven Groupings Model (PDGM) prior to implementation of RCD. In one state however, CMS is not delaying implementation.

We’re well into 2019, and it seems PDGM (Patient-Driven Groupings Model) is among the most discussed healthcare topics at the moment. From industry trade publications to speakers at national conferences, everyone is talking about how PDGM will affect home health agencies in 2020. The information can be insightful, but it can also be overwhelming. Here is a key-point summary that will help your home health agency prepare for 2020, both financially and operationally.

CMS DELAYS RCD UNTIL MARCH 2020

 

Advocates for home health care have achieved a significant triumph regarding the ongoing struggle against implementation of RCD (Review Choice Demonstration).

After a series of sessions reviewing the matter, the Centers for Medicare & Medicaid Services (CMS) released an official statement this past Monday that the RCD will be delayed until March 2, 2020. Originally, implementation of the demonstration was slated to start in Texas on December second of 2019. This would have resulted in home health care providers in the Lone Star state being forced to simultaneously navigate RCD while also dealing with the equally intimidating PDGM (Patient-Driven Groupings Model).

The moment PDGM (The Patient-Driven Groupings Model) takes effect in the year 2020, the Centers for Medicare & Medicaid Services (CMS) looks to see their new edict change the landscape of home health care operations, specifically with regard to double billing. With PDGM representing the largest wholesale revamp in many years, agencies and providers will need to dedicate significant attention to using this year to ensure proper preparation. With the number of changes in store, inevitably some agencies will contest specific aspects of PDGM’s new requirements.

January 2020 OASIS-D Changes

 

OASIS-D to OASIS-D1 Information

OASIS-D is the current version of the OASIS data set. It was implemented on January 1, 2019. OASIS-D introduces new standardized items to support measurement domains mandated by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. New items were also added for standardization to align with assessment sets for other post-acute care settings. Several items were also removed to reduce provider and patient burden. OASIS-D was approved by the Office of Management and Budget (OMB) on December 6, 2018, with an intended expiration date of 12/31/2021.

Illinois Review Choice Demonstration to Begin on June 1

The Center for Medicare Services (CMS) recently released information about the next steps for its Review Choice Demonstration (RCD). Illinois will be the first state to participate with the newest version of this demonstration, beginning  June 1, 2019. The Five (5) state claims review demonstration also includes Ohio, North Carolina, Florida, and Texas.

New EVV Survey Raises Concerns Among Homecare Providers & Industry Officials

As the movement towards mandatory EVV on the federal level continues to march forward, officials at CMS have been steadily preparing for the possible rollout of a national electronic visit verification (EVV) survey. This survey would be a non-optional requirement for agencies providing many types of care, and is intended to strengthen agency accountability, patient care, and reduce the rampant fraud that recent reports have suggested is still on the rise in numerous states.

SPOTLIGHT ON OHIO & THE ODM EVV MANDATE

 

Electronic Visit Verification, also known as EVV, is quickly becoming a federally-mandated requirement which all state Medicaid programs must implement in order to verify that home health, homecare and/or personal care services are delivered to their intended patients. Electronic visit verification is mandated under the 21st Century Cures Act, which was effectively signed into law in 2016 with the intent of decreasing the rampant levels of reported fraud within Medicaid claims filings.

The new EVV mandates require that each state must have a state-wide and properly approved Electronic Visit Verification system fully operational by an implementation deadline of January 1st 2019 for all Medicaid-funded home health agencies providing services, and by the first of January, 2021, for all Medicaid-funded personal care services.