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CMS says the home health Review Choice Demonstration expands to California for billing periods from January 18, 2027, pending paperwork approval

CMS says it is expanding the Review Choice Demonstration for Home Health Services to California for billing periods beginning on or after January 18, 2027, pending approval of revisions to Paperwork Reduction Act (PRA) package CMS-10599. The posting date of that statement was not established. Read it with the emergency paperwork notice CMS published for the same expansion, reported separately in this edition.

Background

The demonstration uses either pre-claim or post-payment review to make sure Medicare payments for home health services are appropriate. The CMS statement says the California expansion will follow the established processes of the demonstration currently operational in Illinois, Ohio, Texas, North Carolina, Florida, and Oklahoma. CMS's emergency paperwork notice for the same expansion lists Illinois, Ohio, North Carolina, Florida and Texas, without Oklahoma.

Who this affects

California home health agencies, including hospital-based agencies.

Why it matters

Inference: if the expansion goes ahead, California home health agencies (HHAs) would come under the demonstration's review options (pre-claim review or the alternatives) for billing periods beginning on or after January 18, 2027. CMS's statement makes that date conditional on approval of the paperwork package and gives no date by which an agency must choose an option.

Scope and timing

Authority status
Announced
Responsible owner
Home Health / Revenue Cycle
Implementation date
2027-01-18 (billing periods beginning on or after; pending PRA approval)

Not established

Announcement date, operational guide and Palmetto/contractor instructions not retrieved.

Sources

Complete edition and supplemental material

This article in the complete report →

Executive triage, source-coverage limitations, context and forward horizons remain in the complete report.

Read the entire Medicare & Medicaid Sweep report →

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