There’s been a flurry of regulatory activity related to Medicare Advantage (MA) in the first half of this year, with many policy actions being the result of extensive advocacy efforts among nursing home organizations.
However, many of the regulations – such as those related to prior authorizations for certain services – as they stand are unclear, leading to less efficacy, said Nicole Fallon, vice president of integrated services and managed care at LeadingAge. Nursing home associations including LeadingAge initiated a data collection effort on Medicare Advantage to present to the Centers for Medicare & Medicaid Services (CMS), in an effort to show how the regulations could be more effective.
Stulick, A. (2024, July 15). CMS issues flurry of Medicare advantage regulation amid audits, but lack of clarity muddies effectiveness. Skilled Nursing News. https://skillednursingnews.com/2024/07/cms-issues-flurry-of-medicare-advantage-regulation-amid-audits-but-lack-of-clarity-muddies-effectiveness/
Improve Medicare Advantage reimbursements with payer contract management that puts payer rules in the hands of clinicians & billers.
