The Nursing Home and Quality & Risk Management member networks have been invited to provide feedback on Medicare Advantage plans related to coverage denials, prior authorizations, etc. to assist LeadingAge in responding to CMS’s proposed rules for Calendar Year 2024 Medicare Advantage, Special Needs Plans and Part D plans. CMS seeks to establish that MA plans must cover services that would be covered under traditional Medicare (FFS) and that once a prior authorization is approved that is covers a “course of treatment”. Details of the proposed rules are summarized here. Members interested in joining this discussion can email Nicole Fallon for Zoom info and questions that will be discussed at the meeting.
