McKnight's April 27, 2023
BALTIMORE — Providers must play an active role in stopping aggressive Medicare Advantage practices that have for years limited access to skilled nursing care, a top managed care expert warned administrators gathered for a national conference here Wednesday.
The Centers for Medicare & Medicaid Services in early April finalized a new rule that seeks to rein in widespread use of pre-authorization requests and service denials by Medicare Advantage plans. In a call with stakeholders Tuesday, CMS Administrator Chiquita Brooks-LaSure called the rule a key element of agency efforts to ensure beneficiaries receive “timely access to medicare care.”
But Maureen McCarthy, president and CEO of Celtic Consulting, warned that providers will have to educate themselves on the Medicare Advantage rule and...
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