Expedited Determinations and Appeals Process and Forms Information for Medicare Part A Beneficiaries in the SNF:
EXPEDITED APPEAL PROCESS IN EFFECT JULY 1, 2005: The new expedited appeal process for Medicare Part A residents in the SNF goes into effect July 1st. This process is similar to the Expedited appeals for managed care residents that went into effect January 2004. Resident will have to be notified within 48 hours of termination of benefits to submit expedited appeal to the QIO. Read Medlearn Matters Article.
SNF PPS Final Rule for RUG Refinement 2006
MEDICARE APPEALS PROCESS EFFECTIVE 05/01/05- CMS has released the new appeals process. A new step has been added. What was perviously known a reconsideration will now be referred to as redetermination and a reconsideration will now be done as the second step to be complete by QIC's.
MDS 2.0 Updates originally to go into effect on 5/1/05 have been delayed for ongoing review until 6/15/05. These changes will be added here when available from CMS.
Have you seen the new Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) notice of noncoverage requirements. This will replace current Notice of Non-Coverage/Determination of Continued Stay forms by October 2004. THIS INFORMATION HAS BEEN POSTED THE CMS WEBSITE. Final Version remains under review as of 5/15/05
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