CMS to expand IRF claim review demonstration to all facilities billing the jurisdiction that includes Alabama, Georgia, Tennessee

The Centers for Medicare & Medicaid Services announced Sept. 25 that it will expand the Inpatient Rehabilitation Facility Review Choice Demonstration to include all IRFs that bill Medicare Administrative Contractor Jurisdiction J, which generally includes Alabama, Georgia and Tennessee. The demonstration, which is currently active for IRFs in Alabama, California, Texas and Pennsylvania, subjects 100% of all Original Medicare IRF claims to either pre-claim or post-payment review. For IRFs newly included in the demonstration, they will need to select either pre-claim or post-payment review by Nov. 13, 2026, and the demonstration will begin Dec. 14, 2026. The AHA has opposed this demonstration, indicating its unnecessarily burdensome nature and will continue to encourage the agency to pause its expansion.