With Pre-Claim on Pause, Providers Seek Answers

The home health industry let out a collective sigh of relief last week after it was announced that the Pre-Claim Review Demonstration (PCRD or PCR) would be put on hold in Illinois and delayed in Florida, where the program was set to begin on April 1. Now, some home health care agencies in Illinois and […]

Home Health Groups Encouraged by CMS Response on Pre-Claim Review

For providers, advocates and industry groups that worked and lobbied for an intervention for the Pre-Claim Review Demonstration (PCRD or PCR) to be changed, the pause in Illinois and delay in Florida announced last week is something to celebrate. However, another bright spot has appeared following a meeting on March 28 between CMS officials, Administrator […]

Pre-Claim Affirmation Rates Rise, But Some Agencies Stay on Sidelines

There’s more good news coming from the federal agency that enacted a controversial home health care program that left the industry reeling. Affirmation rates for the Pre-Claim Review Demonstration (PCRD) currently underway in Illinois continued to rise in the program’s 17th week, according to the Centers for Medicare & Medicaid Services (CMS). Affirmation rates—including claims […]

Federal Lawmakers Seek Pre-Claim Data Before Speaking Up

In light of the decision by the Centers for Medicare & Medicaid Services (CMS) to delay the implementation of the Pre-Claim Review Demonstration in Florida, Texas, Massachusetts and Michigan, home health providers in Illinois say they are reeling as the program is still underway there. Agencies have spoken out about high denial rates on their claims […]

Interdisciplinary Teams Connect the Dots in Home Health Care

Between physical therapy, medication administration, assistance with activities of daily life and more, a home health patient’s care needs can be quite complex and at times prove difficult to manage. That’s why once patients move from an acute setting back to their homes, care coordination and collaboration become more important than ever, according to experts […]