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Tags Posts tagged with "Review Choice Demonstration"

Review Choice Demonstration

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The Centers for Medicare and Medicaid Services (CMS) has released a number of additional and updated documents related to the inpatient rehabilitation facility (IRF) review choice demonstration (RCD). Included in these documents are:

  • An updated and revised Operational Guide — Clarifies key programmatic details regarding the different review choices and other facets of the demonstration.
  • Frequently Asked Questions Document — The FAQ focuses on major areas of confusion on the choice selection and submission processes, the Pre-Claim Review Track, and medical necessity determinations.
  • Transcript and Recording — From the June 27, 2023, special open-door forum on the IRF RCD.

Additional information about the IRF RCD can be found on the CMS IRF RCD web page.

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The Centers for Medicare and Medicaid Services (CMS) conducted a special open door forum on June 27, 2023, that focused on the Review Choice Demonstration (RCD) for inpatient rehabilitation facilities (IRF). Beginning August 21, 2023, the RCD will begin for IRF services in Alabama. CMS has shared that IRFs in Pennsylvania will be included in the next phase of the demonstration. For additional information, there is an RCD web page dedicated to this. The presentation from the June 27 special open door is also available.

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The Centers for Medicare and Medicaid Services (CMS) has announced that they will conduct a special open door forum (ODF) that will focus on the Review Choice Demonstration (RCD) for inpatient rehabilitation facilities (IRFs). The ODF is scheduled for Tuesday, June 27, 2023 from 1:00 pm – 2:30 pm.

By utilizing the RCD, CMS indicates that this demonstration establishes a review choice process for IRF services to test whether such a process improves methods for the investigation and prosecution of fraud, and provides flexibility for IRFs, as well as a risk-based approach to reduce burden on providers demonstrating compliance with Medicare requirements for IRF services. Initial feedback shows that the RCD will have IRFs choose one of two tracks: 100 percent pre-claim review or 100 percent post-payment review, for the first cycle. Additional information has been requested from CMS on these tracks.

Beginning August 21, 2023, CMS will implement the RCD for IRF services in Alabama. The second phase, while no specific timeline has been released, will include Pennsylvania, California, and Texas. Because PA is included in the next phase of the demonstration, RCPA members are encouraged to participate in this ODF.

This ODF will be a Zoom webinar with registration and login instructions below:

Register here in advance for this webinar.
833-568-8864 (Toll Free)
Meeting ID: 160 359 5359
Passcode: 000436

After registering, you will receive a confirmation email containing information about joining the webinar. The presentation will be available on the Review Choice Demonstration for IRF Services web page prior to the call. Feedback and questions on the Review Choice Demonstration for IRF services can be sent via email.

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The Centers for Medicare and Medicaid Services (CMS) recently notified the American Medical Rehabilitation Providers Association (AMRPA) that the rollout of the Review Choice Demonstration (RCD) would begin on August 21, 2023, in Alabama. In previous information released about the RCD, Pennsylvania is most likely to be one of the next states in line for this rollout. Under this demonstration, CMS Medicare Administrative Contractors (MACs) will review all Medicare Fee-for-Service (FFS) claims in select states. CMS will utilize a dedicated website to provide updated information and resources to inpatient rehabilitation facility (IRF) stakeholders.

RCPA is working closely with AMRPA staff and will keep members apprised of developments and updates throughout the demonstration. The RCD website confirms that affected IRFs will have the option to elect pre-claim or post-payment review (and must use the same option for all claims).

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