Review Choice Demonstration (RCD) Updated Cycles for Providers in Illinois

Published 08/13/2020

CMS will restart the RCD following the pause for COVID-19. Home Health claims in all demonstration states with billing periods on or after August 31, 2020, will be subject to review under the requirements of the choice selected.  

RCD Cycle 2 for providers in the state of Illinois has been updated due to the
COVID-19 (PDF, 54 KB) pause. Cycle 2 began on February 1, 2020, and paused after two months. Recently, Palmetto GBA communicated that the remaining four months of the Cycle would begin on August 31, 2020 and end on December 31, 2020. After considering additional stakeholder feedback, CMS has determined that Cycle 2 will now end on September 30, 2020. Affirmation and Claim Approval rates will be calculated based on review decisions made between February 1, 2020, and September 30, 2020. Palmetto GBA will communicate Cycle 2 results to all providers no later than October 31, 2020.

All PCR decisions during the pause will be included in Cycle 2 affirmation rates.  

Palmetto GBA will conduct postpayment review on claims subject to the demonstration that were submitted and paid during the pause. Review results for these claims will not be included in Cycle 2 claim approval rates.

For more information on the resumption of RCD, click
visit the CMS website.

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