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Pre-Claim Review Demonstration for Home Health Services

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In response to our participation in CMS’ June 14th, 2016 Open Door Forum on the Pre-Claim Review Demonstration for Home Health Services, Kornetti & Krafft is developing educational content and products to support your agency efforts to successfully navigate the next 3 years of participation.

This demonstration project, currently limited to 5 states – Illinois, Texas, Florida, Michigan, and Massachusetts – is slated to begin on staggered start dates as follows;

StateAnticipated Start Date
IllinoisAugust 1, 2016
FloridaOctober 1, 2016
TexasDecember 1, 2016
MichiganJanuary 1, 2017
MassachusettsJanuary 1, 2017

and continue for a 3-year period.

This demonstration project supports Medicare’s focus on reduction current practice of “pay and chase” methodology for fraud reduction, by providing support and assistance to HHAs to make sure that documentation (already submitted) sufficiently supports payment for services under the Medicare Part A Home Health benefit, as outlined in the Medicare Benefit Policy Manual – Chapter 7, Home Health.

Please look for upcoming educational content on our website!

Follow this link to the podcast and transcript for the Special Open Door Forum that occurred 6/14/16;

https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/ODF-Podcast-Transcripts.html



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