tci Medicare Compliance & Reimbursement - 2004 Issue 9

Rehab: CORFs Given New M+CO Appeals Responsibilities

5 tips for mastering notification requirements.New fast-track appeals requirements are catching most comprehensive outpatient rehab facilities by surprise, and it's a nasty surprise indeed.As required by a settlement in the Grijalva v. Shalala lawsuit, the Centers for Medicare & Medicaid Services began requiring new notices of termination of coverage for Medicare+Choice enrollees Jan. 1 to facilitate speedy appeals decisions. And the requirements for the fast-track appeals process are translating into extra costs and headaches for CORFs that contract with the Medicare managed care plans.In addition to the termination of coverage notice, CORFs (along with skilled nursing...

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