A new regulation has been released regarding Medicare Advantage plans. If you are providing home health services to a patient enrolled in a Medicare Advantage plan, you are now required to issue the Notice of Medicare Non-Coverage. This notice must include information about the BFCC-QIO, allowing patients the opportunity to appeal decisions related to their discharge. […]
Healthcare providers have been facing significant challenges with PCR (Pre-Claim Review) requests in recent months, following a new directive from CMS (Centers for Medicare & Medicaid Services) to Palmetto GBA. The change in interpretation, which began impacting providers in late November, requires a face-to-face encounter performed by the certifying physician or nurse practitioner (NP) for […]
The Centers for Medicare & Medicaid Services (CMS) has announced that the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model will officially end on December 31, 2024, at 11:59 PM. This decision impacts Medicare Advantage Organizations (MAOs) participating in the Hospice Benefit Component and requires them to make adjustments to ensure continued compliance […]