McKnight's April 8, 2024
A final rule announced by the Centers for Medicare & Medicaid Services Thursday revised the appeals process for Medicare Advantage beneficiaries who have been denied coverage. The new rule should be a significant help for both beneficiaries and long-term care providers, sector leaders said Friday.
The changes are in line with the rule proposed in November and would bring MA appeals more into line with traditional Medicare.
Beneficiaries denied MA coverage will no longer be required to shoulder the cost of their treatment if they do not appeal quickly enough and their appeal is unsuccessful. That old status quo has been a significant barrier to appeals, according to Nicole Fallon, vice president of integrated services and managed care at...
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