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You are here: Home / Blog / CMS delays both pre-claim review and new conditions of participation
Home Health & Hospice

CMS delays both pre-claim review and new conditions of participation

March 31, 2017
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Home health agencies across the nation — especially those in Florida and Illinois — can breathe a sigh of relief knowing that today CMS officially postponed both the effective date of the new Conditions of Participation (CoPs) and the rollout of Pre-Claim Review (PCR) in Florida, originally slated for April 1. PCR is also paused in Illinois, where the project had been active since last August.

Conditions of Participation Effective Date Postponed to 2018
Back in March, CMS proposed delaying new CoPs until January 13, 2018.

UPDATE: On July 7, CMS finalized six-month delay, giving agencies six additional months to digest the comprehensive and fundamental changes on the horizon. However, agencies still won’t have much to make their final preparation before the new CoPs take effect. The final interpretive guidelines for the CoPs won’t be ready until December 2017, and the proposed guidelines will be released at a not-yet-announced date this fall. For more information, read the Federal Register document here.

Pre-Claim Review Delayed in Florida, Paused in Illinois
According to CMS’ website, “As of April 1, 2017, the Pre-Claim Review demonstration will be paused for at least 30 days in Illinois. The demonstration will not expand to Florida on April 1, 2017.” This new delay comes after PCR was temporarily delayed for agencies in Florida, Texas, Massachusetts, and Michigan in late 2016. For more information, read CMS’ official announcement on their website.

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