Midwest October Newsletter
October 19, 20172017 Provider and Risk Adjustment Workshop We're partnering with Carle to present a provider workshop on Thursday, October 26 at the Carle Forum. Doors open at 5:30 p.m., and the workshop starts at 6 p.m.
2017 Provider and Risk Adjustment Workshop We're partnering with Carle to present a provider workshop on Thursday, October 26 at the Carle Forum. Doors open at 5:30 p.m., and the workshop starts at 6 p.m.
CMS Education on Medicare Skilled Nursing and Therapy Services Coverage The Centers for Medicare and Medicaid (CMS) want to remind you that the Jimmo v. Sebelius Settlement Agreement clarified that Medicare covers skilled nursing care and skilled therapy services under its skilled nursing facility, home health, and outpatient therapy benefits when a patient needs skilled care in order to maintain function or to prevent or slow decline or deterioration (provided all other coverage criteria are met). This may reflect a change in practice for those of you who thought that Medicare only covers nursing and therapy services under these benefits when a patient is expected to improve.
CMS Education on Medicare Skilled Nursing and Therapy Services Coverage The Centers for Medicare and Medicaid (CMS) want to remind you that the Jimmo v. Sebelius Settlement Agreement clarified that Medicare covers skilled nursing care and skilled therapy services under its skilled nursing facility, home health, and outpatient therapy benefits when a patient needs skilled care in order to maintain function or to prevent or slow decline or deterioration (provided all other coverage criteria are met). This may reflect a change in practice for those of you who thought that Medicare only covers nursing and therapy services under these benefits when a patient is expected to improve.
After many discussions with providers and partners, we’ve decided to make significant temporary changes in the rollout of our preauthorization program with eviCore. In order to provide additional time for education, communication, and collaboration around this program, we’ll be significantly reducing or eliminating the clinical assessment required for getting therapy preauthorizations.
The Annual Enrollment Period is almost here! We can help you be prepared to field patient questions about Medicare. Providers and their office staff members are invited to join one of our upcoming webinars to learn more about our Medicare Advantage plans.