Skilled Nursing News July 5, 2023
The Medicare Advantage preauthorization process and denials of care are a growing concern across the continuum, and nursing home operators and advocates — as well as federal lawmakers — are pushing more urgently for change.
Such concerns are not new, and already some action has been taken: the Centers for Medicare & Medicaid Services (CMS) has sought to stop diversions of patients away from skilled nursing facilities while ensuring more consistency between MA and traditional Medicare.
Nevertheless, these forthcoming changes haven’t eased the headaches faced by nursing homes nor allayed fears by advocacy groups. And legislative efforts to reign in MA plans need to be stronger, nursing home operators and advocates say.
“Insurance providers won’t pay for patients to stay...
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