Majority of U.S. Seniors Against Pre-Claim Review

The start of the Centers for Medicare & Medicaid Services’ (CMS) pre-claim review demonstration has drawn harsh criticism from many stakeholders in the home health care industry. Now, they may be able to say that seniors themselves don’t like the initiative, either.

Bring Home the Vote, which sponsored the poll, is a national initiative that home health associations and providers use to encourage seniors to register to vote and vote in elections. Bring Home the Vote is supported by the Partnership for Quality Home Healthcare, a coalition of home health providers that recently expressed concern about CMS moving forward with the pre-claim demonstration.

While the results of the recent poll of seniors largely back up the position of the home health associations supporting Bring Home the Vote, the poll itself was undertaken on behalf of Bring Home the Vote by an independent entity—specifically, the polling and market research division of Morning Consult. The organization polled 1,931 registered voters over age 65 nationwide between July 29 and July 30, 2016.


As part of the Medicare pre-claim review demonstration program, home health providers in certain states are required to submit their claims for review to Medicare Administrative Contractors (MACs), who decide if they are correct or send them back to be submitted again. The demonstration is meant to give CMS more control over reimbursements in an industry that has dealt with its fair share of fraudulent billing activity.

Providers, however, have argued that the pre-claim review is not the best way to resolve issues of improper documentation—and seniors across the country tend to agree.

In fact, 83% of the seniors polled by Morning Consult believe that a doctor should be able to prescribe medications and services they choose for their patients without any government interference.

Additionally, 80% of seniors believe that requiring a government contractor to approve claims for Medicare home health care services will likely lead to delayed care for patients who require prompt care, the findings show.

Still, though seniors may not like the idea, almost half—45%—of the respondents believe that government contractor approval of home health services will in fact lead to a reduction in fraudulent home health claims.

Written by Mary Kate Nelson