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CMS has asked the Office of Management and Budget for expedited approval to revise information collection requirements for the Medicare Home Health Review Choice Demonstration, a step toward expanding the program to California. The agency cites concerns about fraud but has not announced when California providers would begin participating; a 14-day public comment period is planned after the notice’s publication.
The Centers for Medicare & Medicaid Services (CMS) has asked for expedited approval to revise information collection requirements for its Medicare home health Review Choice Demonstration, taking a step toward expanding the program to California. CMS cited concerns about fraud in the state’s traditional Medicare home health benefit, but the request does not set a start date for California providers.
CMS filed the notice on Friday with the Office of Management and Budget (OMB). The notice is scheduled to appear in the Federal Register on Nov. 2, 2026, although its text is already available on the Federal Register website. The filing seeks expedited approval for changes to the demonstration’s information collection requirements; it is a step toward expansion, not confirmation that California agencies have begun participating.
The notice says a 14-day public comment period will follow publication. It does not specify when California home health agencies would enter the program, or provide a schedule for implementation. CMS’s request frames the move as an effort to address what the agency describes as significant fraud in California’s traditional Medicare home health benefit.
The RCD uses more rigorous claims review procedures intended to address improper billing. It currently operates in Illinois, Ohio, Oklahoma, North Carolina, Florida and Texas. Under current CMS guidance, agencies that reach a 90% target full provisional affirmation rate, based on at least 10 requests or claims during a six-month review period, can become eligible for additional review choices, including relief from most reviews apart from spot checks.
How California Providers Could Be Affected
If CMS proceeds, California agencies would face the demonstration’s claims-review framework, which may affect how they submit documentation and obtain Medicare payment. The policy has consequences for providers and for the federal program: CMS says the review is intended to combat improper billing, while agencies must navigate the review requirements and any available options.
Supporters have argued that the program’s pre-claim review option can give agencies greater payment certainty by allowing them to address documentation issues before submitting final claims. That could reduce the risk of denials arriving months later, supporters say. These are proponents’ stated benefits, not a finding in the notice about outcomes in California.
The agency’s fraud rationale also concerns public spending and beneficiaries. CMS says improper payments can use Medicare Trust Fund money that could otherwise support needed care, and that beneficiaries may receive care that is not medically necessary. The notice presents these as reasons for urgent action; the filing itself does not provide figures quantifying the alleged fraud or detailing individual cases.
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Existing Review Program and California Debate
RCD is a Medicare demonstration that applies additional review procedures to home health claims. Its current footprint includes six states, and the California filing would move the program toward a seventh state if CMS completes the necessary steps. The OMB request concerns information collection requirements, and is not itself a final announcement of the date or operational details of California participation.
California has repeatedly been identified as a hot spot for home health and Medicare fraud, according to the source report. Some providers have also advocated for expansion. In 2025, Stacey Smith, vice president of public affairs at AccentCare, told Home Health Care News that the company supported expanding RCD to California and nationwide. Her statement reflects a provider’s position; it does not establish CMS’s final implementation plan or the demonstration’s effects.
CMS’s current guidance ties access to certain review choices to a provider’s performance during a six-month review period. Agencies meeting the 90% affirmation target, with at least 10 requests or claims, can qualify for additional choices, including avoiding most reviews except spot checks. The source material does not detail how CMS would apply those arrangements during a California rollout.
“A delay in the expansion means an extended time the public will be harmed through the continuation of significant fraud found in the traditional Medicare home health benefit in California through the waste of taxpayer money, a loss of funds from the Medicare Trust Funds that could have been used for truly needed care, paying for care that is never delivered and beneficiaries potentially receiving non-medically necessary care.”
— CMS, in the notice
Rollout Date and Review Details Awaited
The notice does not say when California agencies would start participating, how many providers would be affected, or what operational timetable CMS would use. The pending comment period also leaves room for feedback before the agency completes the process described in the filing.
The source material provides no figures for the scale or financial value of the fraud CMS cites, and no case-level evidence or response from California providers addressing the agency’s allegations. It also does not explain whether the final requirements or review options for California would differ from those currently applied in the six participating states. The claimed payment-certainty benefits are attributed to supporters, rather than reported as measured outcomes.
Federal Review and Public Comments
The notice is scheduled for Federal Register publication on Nov. 2, 2026, after which a 14-day public comment period is expected. CMS’s request for expedited OMB approval is the current procedural step; the source material does not provide a date for an OMB decision or a final CMS implementation announcement.
Readers should watch for the public comments, any response from CMS, and later guidance that identifies whether and when California agencies will be added. Until those details are published, expansion remains a proposed next step rather than an operating requirement for California providers.
Key Questions
What has CMS announced about California?
CMS filed a request for expedited OMB approval to revise information collection requirements for the Medicare Home Health Review Choice Demonstration, advancing a possible expansion to California. The filing does not establish a launch date.
Is the demonstration already operating in California?
The source material does not say that California agencies have started participating. The notice describes a step toward expansion, and does not specify when participation would begin.
Which states currently participate in RCD?
The demonstration is currently in Illinois, Ohio, Oklahoma, North Carolina, Florida and Texas, according to the report.
What review choices can agencies qualify for?
Under current CMS guidance, an agency that reaches a 90% target full provisional affirmation rate, based on at least 10 requests or claims over a six-month review period, can become eligible for additional choices. These include relief from most reviews, apart from spot checks.
What happens after the notice is published?
A 14-day public comment period is planned after Federal Register publication, scheduled for Nov. 2, 2026. The source does not state when OMB or CMS will make a subsequent decision or announce an implementation schedule.
Source: homehealthcarenews.com
