CMS seeks emergency clearance to expand the home health Review Choice Demonstration to California

Background

The Review Choice Demonstration for Home Health Services uses either pre-claim or post-payment review to make sure Medicare payments for home health services are appropriate; CMS has implemented it in Illinois, Ohio, North Carolina, Florida and Texas, with the option to expand to other states in the Palmetto/JM jurisdiction. Under the Paperwork Reduction Act, federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor.

Who this affects

Medicare-certified home health agencies in California, including hospital-based and health-system-owned agencies, and the Medicare contractors that would review their claims.

Why it matters

Inference: if OMB approves the collection and CMS expands the demonstration, California home health agencies would have to choose a review option and submit documentation to the Medicare contractor before or after claims, which affects intake documentation, billing holds and cash flow. Inference: the removed sentence appears to be the one describing the option to skip review and take a 25 percent payment reduction, so that opt-out may not be available in the revised collection; confirm against CMS operational materials. The notice gives no California start date.

Implementation playbook

1. Decide whether to comment on the information collection. Owner: Home Health leadership. Due: 2026-11-16 (the notice's date).
2. Assess documentation readiness for pre-claim review: intake, face-to-face and plan-of-care documentation, and billing holds. Owner: Home Health clinical leadership and Revenue Cycle. Due: 2026-12-15.
3. Choose a review option when CMS opens selection. Owner: Home Health leadership. Due: when CMS announces it; a CMS page gives billing periods beginning on or after 2027-01-18, pending approval.
4. Check weekly for CMS and Medicare contractor instructions for California. Owner: Compliance. Due: weekly until the start date is confirmed.

Not established

The notice states no California start date, no MAC and no selection deadline. Which sentence the correction removed is identified by its first and last words only; the match to the 25 percent reduction sentence is an inference from the text. OMB action on the emergency request not checked. govinfo PDFs not retrieved (the full text from the Federal Register application programming interface (API) was used).

Sources

• Emergency clearance notice, 91 FR 68960 (govinfo PDF)
• Correction, 91 FR 69565 (govinfo PDF)