What about UPICs? RCD starts in IL on 6/1. QIRT has some questions on how this may affect other medical review activity that is occurring in an RCD state.
CMS announced yesterday that the Review Choice Demonstration (RCD) project will begin in Illinois on June 1, 2019. Prepare now with QIRT's support choices: Readiness Audits, Complete Guides, and a Team of Experts.
Is the new Plan of Care (POC) Requirement reason for alarm? QIRT explains what's actually new and what to do about it.
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.
Home care agencies who have received additional development requests (ADRs) are experiencing an ever-increasing ALJ backlog. The following is part 2 of a 3-part series on the current state of ADRs and the ALJ backlog. Find Part One here. As we mentioned last week, a federal judge ruled that OMHA must seek to reduce the ALJ backlog... Continue Reading →
Home care agencies who have received additional development requests are experiencing an ever-increasing ALJ backlog. An additional development request (ADR) is generated to request documentation from a provider to assist with adjudicating a Medicare claim. Since 2010, the number of claims awaiting an Administrative Law Judge (ALJ) hearing has steadily climbed, along with the wait time for... Continue Reading →
A tightly interwoven loop illustrates the impact of quality reporting on star ratings ... and the importance of the relationship between the two. Star ratings encourage providers to strive for higher levels of quality. They support consumers’ health care decision-making by providing easily recognizable differences in quality when selecting a health care provider. The higher the... Continue Reading →
Let's discuss the RCD implementation delay. The Review Choice Demonstration (RCD) for Home Health Services was scheduled to begin in Illinois on December 10, 2018. Numerous CMS webinars, Palmetto GBA webinars, and a CMS Open Door Forum all said so. However, that date seems to be a mirage, at least for the present time. Due... Continue Reading →
Yet Another Update to TPE (Targeted Probe and Educate) THIS JUST IN! (This post updates a blog written and published on 11/8/18) Medicare Administrative Contractor (MAC) CGS Administrators has just posted its first update to Targeted Probe and Educate (TPE) activity in nearly a year, and immediately updated it. Four more areas to receive additional... Continue Reading →