MedPage Today November 29, 2023
— Groups lament stress to enrollees and billions in hospital losses from coverage delays, denials
Some Medicare Advantage (MA) plans do not intend to abide by the 2024 CMS rule that prohibits them from denying coverage of services that traditional Medicare would cover. Instead, the private plans are using their own rules or terminology to block or delay inpatient care doctors say their patients need, circumventing the federal agency’s intentions.
Those are among concerns the American Hospital Association (AHA) and the Federation of American Hospitals (FAH) expressed last week in letters to CMS based on reports from their members. The organizations are pleading with the agency to tighten some of the language in the rule and enforce provisions that restrict...
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