Skilled Nursing News February 7, 2024
Piece by piece, nursing home operators are seeing stricter government oversight of Medicare Advantage (MA) plans, a welcome relief given that partnerships with such managed care plans have become a huge source of administrative burden for providers in the sector, especially as workforce shortages persist.
Most recently, the Centers for Medicare & Medicaid Services (CMS) in January published its Interoperability and Prior Authorization final rule alongside a proposed payment update for MA and Part D plans. The changes outlined in the federal agency’s final rule aim to streamline prior authorizations and promote easier electronic health record exchanges between providers and insurance plans, while also holding payers more accountable for denials.
Impacted payers, including Medicare Advantage plans, are now required to...
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