CMS Pauses Pre-Claim Review Demonstration for Home Health Services

April 5, 2017
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Rick Gawenda
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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.

After March 31, 2017, and continuing throughout the pause, the Medicare Administrative Contractors will not accept any Pre-Claim Review requests.  During the pause, home health claims can be submitted for payment and will be paid under normal claim processing rules. CMS will notify providers at least 30 days in advance via an update to their website of further developments related to the demonstration.

To access this information on the CMS website as well as pre-claim pause questions and answers, click

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