I was able to find out about what I thought were new regs regarding snf denial
letters.I found out ithas to do with managed medicare programs.Apparently there was a
class action lawsuit brought by enrolles in medicare risk based programs.They felt the
companies failed to give them a fair termination process.In Mass as of Jan 1st,our
Medicare Quality Improvement Organization will conduce any appeals.The snf will now
need to give the beneficiary an advanced 48 hour notice before the managed care
company does..I won't get into all the details but I am sure it may differ state to
state.We deal with several M-C organizations but only 1 has discussed this with us.I
guess as usual,the snf has to take the lead.
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