CMS Proposes Highly Anticipated Fix for Medicare Advantage Appeals

CMS PROPOSES HIGHLY ANTICIPATED FIX FOR MEDICARE ADVANTAGE APPEALS

Medicare Advantage appeals can be a highly emotional process for patients and families, not to mention the lengthy, multi-layered approach can cause unnecessary gaps in care or carry a high likelihood of rehospitalization following nursing home care.

“The change would address one of the most significant challenges faced by nursing homes and their patients in the shift to managed care: insurers who have been able to decide single-handedly whether their own denials of care or shortened stays were appropriate.”

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