Skilled Nursing News January 2, 2024
The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that aims to establish appeals processes for certain Medicare beneficiaries in Original Medicare who undergo a change in their hospital status, often triggering a denial of inpatient and skilled nursing care.
The proposed rule is a result of a 2011 nationwide class action case, which sought to grant Medicare beneficiaries the right to challenge their placement as outpatients receiving observation services during their hospital stay.
The change in hospital status pertains specifically to individuals initially admitted as inpatients but later reclassified as outpatients. The proposed rule addresses the appeal rights for those who meet specific eligibility criteria in such circumstances, which would create new requirements for operators, the...
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