CMS moves to bring the home health Review Choice Demonstration to California, with a 14-day comment window

CMS filed a notice with the Federal Register on Oct. 30, 2026, asking the Office of Management and Budget to approve, on an emergency basis, a revised information collection for the home health Review Choice Demonstration (RCD). Approval, CMS wrote, is "essential to ensure" that RCD "is expanded to California within the specified timeframe" (public inspection copy, FR Doc. 2026-22297). It is scheduled to publish Nov. 2. Home Health Care News reported it the same day.

Key facts - Document: CMS-10599 (OMB control number 0938-1311), FR Doc. 2026-22297 - Filed Oct. 30, 2026; publishes in the Federal Register Nov. 2 - Asks for emergency OMB clearance so RCD can expand to California - Comment period: 14 days after the notice is displayed - California start: billing periods beginning on or after Jan. 18, 2027, if OMB approves the paperwork revision (CMS, Nov. 2) - Choice selection: Nov. 16 to Dec. 16, 2026, for agencies billing Wellpoint Federal (MAC Jurisdiction 6) - Current RCD states, per CMS: Illinois, Ohio, Texas, North Carolina, Florida, Oklahoma

What is the Review Choice Demonstration?

RCD is CMS's claim-review program for home health agencies in selected states. Agencies pick 100% pre-claim review, where the Medicare contractor reviews documentation before the final claim, or 100% postpayment review. After six months, an agency with a 90% full provisional affirmation rate on at least 10 requests or claims can choose lighter options, down to a small spot-check sample, according to CMS's RCD page. CMS runs it under its fraud-demonstration authority in section 402(a)(1)(J) of the 1967 Social Security Amendments. Our Illinois RCD explainer walks through each choice.

Which states are in it now?

Six, per CMS's page as checked Oct. 30: Illinois, Ohio, Texas, North Carolina, Florida and Oklahoma. CMS extended the program for five years effective June 1, 2024.

The new notice does not match that list. Its boilerplate says CMS has implemented RCD in "Illinois, Ohio, North Carolina, Florida, and Texas," leaving out Oklahoma, which joined Dec. 1, 2023. It also still describes a 25% payment reduction for agencies that skip review. CMS's page says that option, Choice 3, was removed from the initial choices in the 2024 extension. We treat CMS's page as current.

What does the notice actually change?

On paper, it revises the paperwork approval that lets Medicare contractors collect RCD documentation. CMS asks OMB to skip normal clearance because "public harm is reasonably likely" otherwise, citing what it calls "significant fraud" in traditional Medicare home health in California. The notice's annual burden estimate: 4,700 respondents, 3,173,016 responses and 1,600,608 hours. It does not say how many of those are California agencies, and it does not name the contractor that would review California claims. The text still describes expansion "to other states in the Palmetto/JM jurisdiction."

When could California agencies be affected?

The notice gives no date, and HHCN also reported that none is specified. Comments are due 14 days after the notice is displayed. Update, Oct. 31: The Federal Register's listing for the Nov. 2 issue now gives the deadline: "Comments must be received by November 16, 2026" (Federal Register document page). That matches our earlier count.

Update, Nov. 2: CMS has now posted the dates on its RCD page. It says it "will be implementing" the demonstration in California "for billing periods beginning on or after January 18, 2027," and that implementation "is dependent on approval" of the CMS-10599/OMB 0938-1311 paperwork revision. The demonstration covers all California home health agencies that bill Medicare Administrative Contractor Jurisdiction 6, Wellpoint Federal. The choice selection period runs Nov. 16 to Dec. 16, 2026. Agencies choose Choice 1, pre-claim review, or Choice 2, postpayment review, and those that don't choose default to postpayment review. CMS says California will follow the processes already used in the Jurisdiction M states. The notice itself published Nov. 2 at 91 FR 68960, with comments due Nov. 16.

For a sense of lead time, look at Oklahoma, the last state added. CMS announced it on Sept. 1, 2023, opened choice selection Oct. 16 to Nov. 15, 2023, and started reviews Dec. 1, 2023, according to its update log.

What should California agencies watch?

• The comment deadline, Nov. 16, 2026. Comments go through regulations.gov, citing CMS-10599 or 0938-1311.
• Whether OMB grants the emergency approval CMS says implementation depends on.
• Wellpoint Federal's choice-selection instructions, which CMS's page links, before the Nov. 16 to Dec. 16 window.
• Documentation habits now. Under pre-claim review, the full record goes to the contractor before the final claim.

This lands while CMS's nationwide enrollment moratorium for new home health agencies and hospices nears its six-month mark around Nov. 13. We will update this story if OMB acts or CMS changes the dates.

Sources

• Federal Register public inspection, CMS-10599 emergency clearance notice, FR Doc. 2026-22297, filed Oct. 30, 2026 (PDF)
• Federal Register, FR Doc. 2026-22297 listing for Nov. 2, 2026 (comments due Nov. 16, 2026)
• CMS, Review Choice Demonstration for Home Health Services
• Home Health Care News, Oct. 30, 2026

Track every MAC change: our Medicare jurisdictions tracker lists CMS and MAC bulletins by jurisdiction.

This item has not been clinically reviewed. It is general information, not clinical, billing or legal advice.

Drafted with AI assistance from primary sources. Written and edited by the Home Health Brief newsroom under Monsaur Othman's editorial standards. Read how we use AI, our editorial policy and our corrections policy.

Informational only, not billing, legal or clinical advice. Check the linked primary source and your Medicare Administrative Contractor.