CHA News

CMS Seeks Additional Comments on Inpatient Rehabilitation Facility Review Choice Demonstration

For rehabilitation leaders, directors of reimbursement, HIM professionals

The Centers for Medicare & Medicaid Services (CMS) has opened an additional 30-day comment period for the proposed inpatient rehabilitation facility (IRF) review choice demonstration.

Under the demonstration, IRFs will choose either pre-claim or post-claim review for all claims. Once an IRF reaches a 90% claim approval, it may choose to be released from 100% claim review and will continue to be subject to a spot check of 5% of its claims to ensure continued compliance.

CMS proposes to implement the demonstration in Alabama, then expand to California, Pennsylvania, and Texas. CMS has not announced a start date for the demonstration. Comments on the current information collection request are due Oct. 8.

CHA submitted comments on behalf of members during the prior 60-day comment period on the demonstration, and CMS has also provided a summary of responses to stakeholder comments.