In an abrupt turn around CMS announced yesterday that the
expansion of the Pre-Claim Audit for home health agencies in the states of
Florida, Texas, Massachusetts, and Michigan has been placed on hold. CMS intends to provide at least a 30-day
notice before that move forward.
CMS stated the delay is based on the early information from
the state of Illinois. They also
indicated that additional education is needed before they can expand this
program to the other states.
We can thank the various trade organizations, members of
Congress, and public outcry for this delay.
Unfortunately, the program is still moving forward in Illinois. We all need to continue to press our members
of Congress to stop the program in Illinois and make the necessary changes
before the program moves forward. A
letter from both Florida US Senators, they recommend if the program moves
forward it should be scaled down approach with a random sample of a small
number of claims.
Dixon Healthcare Solutions, Inc., has received information
that the program is flawed with many failures points. Some agencies are receiving a denial rate of
80% on their initial reviews. The MAC (Palmetto
GBA) has lost paperwork. It is taking
hours to submit the paperwork. The MAC’s claim review workload has increased
by 40 to 50 times. The whole program is
a mess.
Link to CMS Announcement
No comments:
Post a Comment