VNAA and the Alliance Release Joint Statement on CMS Pre-Claim Demonstration - VNAA - The Visiting Nurse Associations of America Skip to Navigation
On June 8, the Centers for Medicare and Medicaid Services released their plans to move forward with prior authorization, now dubbed the Pre-Claim Review Demonstration for Home Health Services. On June 10, VNAA and the Alliance issued the following response.

The Visiting Nurse Associations of America (VNAA) and the Alliance for Home Health Quality and Innovation (the Alliance) are extremely disappointed that the Centers for Medicare and Medicaid Services (CMS) dismissed the comments and concerns of 122 Members of Congress and almost 250 different health care service providers -- physicians, hospitals, home health -- and pushed forward a prior authorization demonstration for home health care in five states.  
 
CMS advanced this demonstration outside of a traditional and responsible rulemaking process and has fast-tracked implementation of a far-reaching and high-impact program over the strong concerns and objections of multiple stakeholder groups. VNAA believes this demonstration will jeopardize patients in the five impacted states who will not receive timely care.  
 
The Pre-Claim Review Demonstration for Home Health Services is neither an appropriate nor effective vehicle to find and eliminate fraud in home health care. VNAA and the Alliance again suggest and stand ready to support CMS initiatives to use targeted interventions focused on likely fraudulent practices evident from the analysis of Medicare claims. A targeted approach would be more effective at addressing fraud and abuse, less costly and less detrimental to the good actors in home health care, as well as to patients. 

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