RCD and UPICs – Part 2

QIRT Alerts' April 9th blog posed questions about the relationship between RCD and UPICs. QIRT experts asked: what happens when you have a Review Choice Demonstration (RCD) project and are under the Unified Program Integrity Contractor (UPIC) reviews? And we followed that with many more questions. Since then, "The Review Choice Demonstration HH Team" provided... Continue Reading →

RCD: More on the CMS FAQs Update

Last week, CMS updated its Frequently Asked Questions (FAQ) on the pending Review Choice Demonstration (RCD) project. Some of these merit additional scrutiny and comment since the selection window (via Palmetto GBA’s eServices portal) has started for Illinois home care agencies. Taken from the “Review Choice Demonstration (RCD) for Home Health Services Frequently Asked Questions (FAQs)”, updated 4/18/19.... Continue Reading →

RCD: CMS FAQs Add Some Clarity

Last week, CMS updated its Frequently Asked Questions (FAQ) on the pending Review Choice Demonstration (RCD) project. Some of these merit additional scrutiny and comment since the selection window (via Palmetto GBA’s eServices portal) has started for Illinois agencies. From the “Review Choice Demonstration (RCD) for Home Health Services Frequently Asked Questions (FAQs)”, updated 4/18/19: Question... Continue Reading →

The Journey of Quality Cycle Management

The Requirements for Long-term Viability in Home Health The following article, written by Corinne Kuypers-Denlinger, Vice President, Post-Acute Growth Strategies at QIRT, was originally published in HomeCare Magazine. Kuypers-Denlinger explores the importance of complete reassessment by home care agencies in advance of the new Patient Driven Groupings Model (PDGM). Agencies will find that they must... Continue Reading →

Another Home Health “Compare” to Make

In reviewing many home health denials, medical reviewers often identify patterns that highlight areas of focus. One of these patterns relates to therapy requirements. Agencies must have orders for therapy and show therapy service is skilled, reasonable, and necessary. In addition, the requirement for a 30-day therapy reassessment must occur. And it is this requirement... Continue Reading →

Backlog to the Future? Part 3

Home care agencies who have received additional development requests (ADRs) are experiencing an ever-increasing ALJ backlog. The following is the final part of a 3-part series on the current state of ADRs and the ALJ backlog.

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