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If you鈥檙e wondering how the 5 percent spot check option will work under the Review Choice Demonstration, a newly updated frequently asked questions set from Medicare can tell you.

HHAs may elect the spot check option only once they鈥檝e hit a 90 percent affirmation threshold under RCD for six months. Or in Illinois, they were able choose it if they reached such a rate under the previous Pre-Claim Review demonstration.

Under the option, 鈥�Palmetto GBA will suspend 5 percent of claims over a 6 month period for prepayment review,鈥� the Centers for Medicare & Medicaid Services explains in the updated FAQs. 鈥淭he 5 percent is based upon a provider鈥檚 claim submission average from the previous 6 months.鈥�

See the expanded 108-question set at 鈥� scroll down to the 鈥淒ownloads鈥� box.