The Centers for Medicare & Medicaid Services (CMS) is moving to expand the Medicare home health Review Choice Demonstration (RCD) to California, citing fraud concerns.
RCD is currently in place in Illinois, Ohio, Oklahoma, North Carolina, Florida and Texas. CMS filed a notice on Friday requesting expedited approval from the Office of Management and Budget to revise the demonstration’s information collection requirements. This process would be a step toward allowing CMS to expand RCD to California.
The notice is scheduled for publication on Nov. 2, but the unpublished text is available on the Federal Register website.
In the notice, CMS said emergency is necessary to prevent public harm.
“A delay in the expansion means an extended time the public will be harmed through the continuation of significant fraud found in the traditional Medicare home health benefit in California through the waste of taxpayer money, a loss of funds from the Medicare Trust Funds that could have been used for truly needed care, paying for care that is never delivered and beneficiaries potentially receiving non-medically necessary care,” the notice read.
California has been repeatedly identified as a hot spot for home health and Medicare fraud.
The notice does not specify when California agencies would begin participating in RCD. It provides for a 14-day public comment period following publication in the Federal Register.
RCD involves more rigorous claims review procedures meant to combat improper billing.
Under current CMS guidance, agencies meeting a 90% target full provisional affirmation rate, based on at least 10 requests or claims during a six-month review period, become eligible for additional review choices, including relief from most reviews except for spot checks.
Some providers have previously advocated for expanding RCD to California. Stacey Smith, vice president of public affairs at AccentCare, told Home Health Care News in 2025 that the company supported expansion to California and nationwide.
Supporters say RCD’s pre-claim review option provides greater payment certainty by allowing agencies to address documentation issues before submitting final claims, reducing the risk of denials months later.
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