Pre-Claim Review Demonstration For Home Health Services (CMS-10599)

The Centers for Medicare & Medicaid Services (CMS) is requesting the Office of Management and Budget (OMB) approval for the Pre-Claim Review Demonstration for Home Health Services. This demonstration would help assure that payments for home health services are appropriate before the claims are paid, thereby preventing fraud, waste, and abuse. CMS proposes performing prior authorization before processing claims for home health services in: Florida, Texas, Illinois, Michigan, and Massachusetts.

The latest form for Pre-Claim Review Demonstration For Home Health Services (CMS-10599) expires 2022-02-28 and can be found here.

HH Demo Fax and Electronic Submissions and Resubmissions (Illinois, Florida, Texas)

Federal Enterprise Architecture: Health - Health Care Services