Here’s another article that provides an update to the Pre-Claim Review (PCR) Demonstration. I remain hopeful that the demonstration will be abandoned and a more targeted approach at combating fraud is developed.

-Rob Santos

“The Pre-Claim Review Demonstration, a recent Medicare home health pilot program from the Centers for Medicare & Medicaid Services (CMS), is one of many new requirements that home health agencies across the country could have to adopt depending on the outcome of recent actions being taken by industry organizations, stakeholders and Congress to extend the delay or withdraw it altogether. Created to enforce a more proactive oversight strategy on Medicare home health coverage in an effort to reduce fraud and abuse, the pre-claim review’s pilot phase was to begin with implementation in Illinois, Florida and Texas in 2016, then Michigan and Massachusetts in 2017—all states with soaring fraud, abuse and over-spending rates.”

For the full article please click here.